title: Family functioning in families of first-episode psychosis patients as compared to chronic mentally ill patients and healthy controls.
abstract: The present study aimed to investigate possible differences in family environment among patients experiencing their First Episode of Psychosis (FEP), chronic patients and controls. Family cohesion and flexibility (FACES-IV) and psychological distress (GHQ-28) were evaluated in families of 50 FEP and 50 chronic patients, as well as 50 controls, whereas expressed emotion (FQ) and family burden (FBS) were assessed in families of FEP and chronic patients. Multivariable linear regression analysis, adjusted for confounders, indicated impaired cohesion and flexibility for families of FEP patients compared to controls, and lower scores for families of chronic patients compared to those of FEP patients. Caregivers of chronic patients scored significantly higher in criticism, and reported higher burden and psychological distress than those of FEP patients. Our findings suggest that unbalanced levels of cohesion and flexibility, high criticism and burden appeared to be the outcome of psychosis and not risk factors triggering the onset of the illness. Furthermore, emotional over-involvement both in terms of positive (i.e. concern) and negative behaviors (i.e. overprotection) is prevalent in Greek families. Psychoeducational interventions from the early stages of the illness should be considered to promote caregivers' awareness regarding the patients' illness, which in turn, may ameliorate dysfunctional family interactions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece; Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece. Electronic address: koutra.k@gmail.com.
authors.forename: Katerina
authors.initials: K
authors.lastname: Koutra
authors.affiliation: Department of Psychology, University of Crete, Rethymnon, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Triliva
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Roumeliotaki
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece.
authors.forename: Zacharias
authors.initials: Z
authors.lastname: Stefanakis
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Basta
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece.
authors.forename: Alexandros N
authors.initials: AN
authors.lastname: Vgontzas
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D002908:Chronic Disease; D017281:Cost of Illness; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology
keywords: Expressed emotion; Family burden; Family functioning; First episode psychosis; Psychological distress