Summary
In this article the consequences for those in close contact with a severely disturbed psychiatric patient, the burden of the family, are elaborated within an integrative framework. Burden areas are described and their objective and subjective dimensions are distinquished. The framework comprises three approaches: the systems approach, role theory and the stress process. An outline of the more important burden instruments developed up to now and suggestions for further research are given.
Similar content being viewed by others
References
Barrett J, Kurionsky J, Gurland B (1972) Community tenure following emergency discharge. Am J Psychiatry 128: 958–964
Billings AG, Moos RH (1982) Psychosocial theory and research on depression: an integrative framework and review. Clin Psychol Rev 2: 213–237
Brown GW, Carstairs GM, Topping G (1958) Post-hospital adjustment of chronic mental patients. Lancet II: 685–689
Brown GW, Rutter M (1966a) The measurement of family activities and relationships. Hum Relat 19: 239–263
Brown GW, Bone M, Dalison BH, Wing JK (1966b) Schizophrenic and social care. A comparative follow-up study of 339 schizophrenic patients (Maudsley Monographs No 17). Oxford University Press, Oxford
Brown GW, Birley JLT, Wing JK (1972) Influence, of family life on the course of schizophrenic disorder: a replication. Br J Psychiatry 121: 241–258
Cobb S (1976) Social support as a moderator of life stress. Psychosom Med 38: 300–314
Coyne JC, Kessler RC, Tal M, Turnbull J, Wortman CB, Greden JF (1987) Living with a depressed person. J Consult Clinical Psychology 55: 347–352
Creer C, Wing JK (1974) Schizophrenia at home. Institute of Psychiatry, London
Creer C, Sturt E, Wykes T (1982) The role of relatives In: Wing JK (ed) Longterm Community care experience in a London borough. Psychol Med Monogr [Suppl 2]: 29–39
Deykin E (1961) The reintegration of the chronic schizophrenic patient discharged to his family and community as perceived by the family. Ment Hygiene 45: 235–246
El Islam MF (1979) A better outlook for schizophrenics living in extended families. Br J Psychiatry 135: 343–347
El Islam MF (1982) Rehabilitation of schizophrenics by the extended family. Acta Psychiatr Scand 65: 112–119
Engel GL (1980) The clinical application of the biopsychosocial model. Am J Psychiatry 137: 535–544
Fadden GB (1984) The relatives of patients with depressive disorders: a typology of burden and strategies of coping. M. Phil Thesis. Institute of Psychiatry, University of London
Fadden G, Bebbington P, Kuipers L (1987) Caring and its burdens. A study of the spouses of depressed patients. Br J Psychiatry 151: 660–667
Freeman HE, Simmons OG (1958) Mental patients, in the community. Family settings and performance level. Am Sociol Rev 22: 147–154
Freeman HE, Simmons OG (1959) Social class and posthospital performance levels. Am Sociol Rev 24: 345–451
Gibbons JS, Horn SH, Powell JM, Gibbons JL (1984) Schizophrenic patients and their families: a survey in p psychiatric service based on a DGH unit. Br J Psychiatry 144: 70–77
Giel R, Arongo MV de, Hafeiz Babikir A (1983) The burden of mental illness on the family. Acta Psychiatr Scand 68: 186–201
Grad J, Sainsbury P (1963) Mental illness and the family. Lancet I: 544–547
Grad J, Sainsbury P (1968) The effects that patients have on their families in a community care and a control psychiatric service. Br J Psychiatry 114: 265–278
Gubman GD, Tessler RC, Willis G (1987) Living with the mentally ill: factors affecting household complaints. Schizophr Bull 13: 727–736
Herz MI, Endicott J, Spitzer RL (1977) Brief hospitalization: a two-year follow-up. Am J Psychiatry 134: 502–507
Hoenig J, Hamilton MW (1966a) The schizophrenic patient in the community and the effect on the household. Int J Soc Psychiatry 26: 165–176
Hoenig J, Hamilton MW (1966b) The burden on the household in an extramural psychiatric service. In: Freeman HL, Farndale WAJ (eds) New aspects of the mental health services. Pergamon. Oxford, pp 612–635
Hoenig J (1968) The de-segregation of the psychiatric patients. Proc R Soc Med 61: 115–120
Jacob M, Frank E, Kupfer DJ, Carpenter LL (1987) Recurrent depression: an assessment of family burden and family attitudes. J Clin Psychiatry 44: 395–400
Knights A, Hirsch SR, Platt SD (1980) Clinical change as a function of brief admission to hospital in a controlled study using the Present State Examination. Br J Psychiatry 137: 170–180
Kreisman D, Joy V (1974) Family response to the illness of a relative. A review of the literature. Schizophr Bull 1: 34–57
Lazarus RS, Cohen JB (1977) Environmental stress. In: Altman I, Wohlwill JF (eds) Human behaviour and the environment: current theory and research, vol 1. Plenum, New York pp 90–121
Lazarus RS (1981) The stress and coping paradigm. In: Eisdorfer C, Cohen A, Kleinman A, Maxim P (eds) Theoretical basis for psychopathology, Spectrum, New York, pp 177–214
Mandelbrote B, Folkard S (1961) Some factors related to outcome and social adjustment in schizophrenia. Acta Psychiatr Scand 37: 223–235
Methorst GJ (1985) Mannen en vrouwen van psychiatrische patienten, Thesis, Wageningen
Noh S, Turner RJ (1987) Living with psychiatric patients: implications for the mental health of family members. Soc Sci Med 25: 263–271
Noh S, Avison WR (1988) Spouses of discharged psychiatric patients: factors associated with their experience of burden. J Marriage Fam 50: 377–389
Pai S, Kaipur RL (1981) The burden on the family of a psychiatric patient; development of an interview schedule. Br J Psychiatry 138: 332–335
Pai S, Kaipur RL (1982) Impact of treatment intervention of the relationship between dimensions of clinical psychopathology, social dysfunction and burden on the family. Psychol Med 12: 651–658
Pasamanick B, Scarpitti FR, Dinith S (1967) Schizophrenics in the community; an experimental study in the prevention of hospitalization. Appleton Century Crofts, New York
Pearlin LI, Schooler C (1978) The structure of coping. J Health Soc Behav 19: 2–21
Pearlin LI, Lieberman MA, Managhan EG, Mullan JT (1981) The stress process. J Health Soc Behav 22: 337–356
Platt S (1981) Social adjustment as a criterion of treatment success: just what are we measuring? Psychiatry 44: 95–112
Platt S (1985) Measuring the burden of psychiatric illness on the family; an evaluation of some rating scales. Psychol Med 15: 383–393
Platt S, Weyman A, Hirsch S, Hewett S (1980) The Social Behaviour Assessment Schedule (SBAS); rationale, contents, scoring and reliability of a new interview schedule. Soc Psychiatry 15: 43–55
Platt S, Weyman A, Hirsch S (1983) Social Behaviour Assessment Schedule (SBAS), 3rd edn. Windsor, Berkshire: NFER-Nelson
Rabkin J (1972) Opinions about mental illness, a review of the literature. Psychol Bull 77: 153–171
Raymond ME, Slaby AE, Lieb J (1975) Familial response to mental illness. Soc Casework 56: 492–498
Sainsbury P, Grad J (1962) Evaluation of treatment and services. In: The burden on the community. A symposium. Oxford University Press, London
Sainsbury P, Grad J (1966) Evaluating the community psychiatric service in Chichester. Aims and methods of research. Milbank Q 44: 231–242
Schene AH (1986) Thuis bezorgd; een literatuurstudie naar het verschijnsel “Burden on the family”. NcGv, Utrecht
Schene AH (1987) The burden on the family scale. Department of Ambulatory and Social Psychiatry, University of Utrecht, Utrecht
Spitzer RL, Giboon M, Endicott J (1971) Family evaluation form. New York State Department of Mental Hygiene, New York
Tessler RC, Killian LM, Gubman GD (1987) Stages in family response to mental illness; an ideal type. Psychosoc Rehabil J 10: 3–16
Tessler R, Fisher G, Gamache G (1989) A role strain approach to the measurement of family burden: the properties and utilities of a new scale. Paper presented at the Annual meeting of the Eastern Sociological Society, Baltimore
Treudley MB (1946) Mental illness and family routines. Ment Hygiene 15: 407–418
Turner RJ (1983) Direct, indirect and moderating effects of social support on psychological distress and associated conditions. In: Kaplan HB (ed) Psychosocial stress, trends in theory and research. Academic, New York, pp 105–156
Waalker VN, MacBriddle A, Vachon MLS (1977) Social support networks and the crisis of bereavement. Soc Sci Med 11: 35–41
Wing JK, Monck E, Brown GW, Carstairs GM (1964) Morbidity in the community of schizophrenic patients discharged from London Mental Hospitals in 1959. Br J Psychiatry, 110: 10–21
Yarrow M, Schwarz C, Murphy H, Deasy L (1955) The psychological meaning of mental illness in the family. J Soc Issues 11: 12–24
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schene, A.H. Objective and subjective dimensions of family burden. Soc Psychiatry Psychiatr Epidemiol 25, 289–297 (1990). https://doi.org/10.1007/BF00782883
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00782883