n Acta Criminologica: Southern African Journal of Criminology - The family system of schizophrenic state patients compared with other schizophrenic patients

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Courts are increasingly placing schizophrenic patients in the care of their families instead of committing them to institutions. It has been shown in other countries that families cope in varying degrees with this burden and that the level of expressed emotion impacts on the relapse rate in patients. A study was undertaken to examine the difference between family support systems of institutionalised patients and those of patients staying with their families. It has been established in earlier studies that close contact with family, the communicative atmosphere found at home, and constant treatment with medication are effective in the treatment of the schizophrenic. Other studies with subjects from lower socio-economic status indicated that the level of family expressed emotion is higher. It was also found that high expressed emotion is contributory to the high relapse rate, in comparison to neutral and low expressed emotion. Relatives with a high expressed emotion show a more immediate response style and a greater amount of speech. The greater the emotion expressed in communication when talking about the patient, the worse the prognosis, especially with the relatives who are relatively hostile, or show a high degree of emotional over-involvement with patients.

Although the sample was too small to draw conclusive evidence, certain trends were noted. The study has revealed very important emotional aspects of groups of families. The families of schizophrenia patients shared common emotions pertaining to high expressed emotion, family bonding and acceptance of the loss due to schizophrenic disorder in the family, which can be contributed to extended family cohesion. The most significant feature that was found, is the need for therapeutic groups for families and the understanding that their role is important in family system therapy as treatment modality.


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