scholarly journals The Role of the Family in the Course and Treatment of Bipolar Disorder

2007 ◽  
Vol 16 (4) ◽  
pp. 192-196 ◽  
Author(s):  
David J. Miklowitz
Keyword(s):  
Bipolar Disorder ◽  
Expressed Emotion ◽  
Psychosocial Interventions ◽  
Developmental Pathways ◽  
Psychosocial Stressors ◽  
At Risk Children ◽  
The Family ◽  
Initial Onset ◽  
Patterns Of Interaction

Bipolar disorder is a highly recurrent and debilitating illness. Research has implicated the role of psychosocial stressors, including high expressed-emotion (EE) attitudes among family members, in the relapse–remission course of the disorder. This article explores the developmental pathways by which EE attitudes originate and predict relapses of bipolar disorder. Levels of EE are correlated with the illness attributions of caregivers and bidirectional patterns of interaction between caregivers and patients during the postepisode period. Although the primary treatments for bipolar disorder are pharmacological, adjunctive psychosocial interventions have additive effects in relapse prevention. Randomized controlled trials demonstrate that the combination of family-focused therapy (FFT) and pharmacotherapy delays relapses and reduces symptom severity among patients followed over the course of 1 to 2 years. The effectiveness of FFT in delaying recurrences among adolescents with bipolar disorder and in delaying the initial onset of the illness among at-risk children is currently being investigated.

Schizophrenia and delusional disorders

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Illness ◽  
Expressed Emotion ◽  
Psychosocial Interventions ◽  
Explanatory Models ◽  
Family Factors ◽  
Double Bind ◽  
Popular Imagination ◽  
Maintenance Medication ◽  
The Family

Schizophrenia is the iconic mental illness. This chapter describes the evolution of the concept by doctors in the early mental hospitals through to modern classifications of its subtypes. The nature/nurture controversy has been particularly fraught in schizophrenia and the possible role of the family in its genesis is considered in detail. Explanatory models such as the ‘schizophrenogenic mother’ and the ‘double bind’, although now only historical, are described because of their hold on the popular imagination. Family factors (‘expressed emotion’) in the maintenance of the disorder are also considered. The role of maintenance medication, clozapine, the identification of relapse signatures, early intervention, and psychosocial interventions are also described.

The family and compliance in schizophrenia: the influence of clinical variables, relatives' knowledge and expressed emotion

2002 ◽  
Vol 33 (1) ◽  
pp. 91-96 ◽  
Author(s):  
W. SELLWOOD ◽  
N. TARRIER ◽  
J. QUINN ◽  
C. BARROWCLOUGH
Keyword(s):  
Social Functioning ◽  
Expressed Emotion ◽  
Family Intervention ◽  
Psychotic Symptoms ◽  
Number Of Factors ◽  
The Family ◽  
Two Factors ◽  
The Subject ◽  
The Relationship

Background. A variety of factors are related to compliance with medication in schizophrenia, but little attention has been paid to the role of families. Carers' knowledge or expressed emotion (EE) may be related to compliance. The aim of the present study was to evaluate the relevance of these two factors, as well as their relationships with other variables for the prediction of compliance.Method. A sample of patient–carer pairs (N=79) involved in a family intervention for schizophrenia trial was recruited. Compliance, symptoms, social functioning and attitudes to their carers were assessed in patients. Carers' EE, knowledge and psychopathology were also evaluated.Results. A number of factors were related to compliance, including carers' EE and patients' psychotic symptoms, which contributed independently to not taking medication. Carers' knowledge about schizophrenia and other groups of symptoms was not related to compliance.Conclusions. EE may be an important factor to account for in the understanding of patients' compliance and the direction of the relationship between EE and compliance should be the subject of further study.

scholarly journals Quality of Life in Schizophrenia and Bipolar Affective Disorder

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Pratima
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Affective Disorder ◽  
Expressed Emotion ◽  
Bipolar Affective Disorder ◽  
Poor Quality ◽  
Living Environment ◽  
The Family ◽  
Bipolar Patients

Family caregivers of persons with bipolar disorder and schizophrenia experience high level of burden and compromised quality of life. A considerable amount of burden on the caregivers often leads to display of certain attitudes towards persons with severe mental illness called expressed emotion, which then leads to poor quality of patients as well. Although numerous studies dealing with these issues separately are present, but studies dealing with relationship, using mixed methodology, among these issues are scarce. The aim of the present study was to understand how actually the construct of quality of life in different demographic conditions affect life conditions of schizophrenic and bipolar patients and determining relapse. The present study was designed mainly to assess the quality of life on patients and the families of a particular group of patients namely those with schizophrenia and bipolar disorder. The objectives if the present research were to study: (i) the quality of life of patients with Schizophrenia and Bipolar Affective disorder. (ii) the quality of life of caregivers of patients with Schizophrenia and Bipolar Affective disorder. Patients with disorders such as schizophrenia and bipolar affective disorder are more likely to relapse when there is high expressed emotion present in their living environment. The stress from the remarks and attitudes of the family is overwhelming because they feel like the cause of the problems. The patient then falls into the cycle of relapse. The only way to escape this vortex for the family is to go through therapy together to prevent the relapse. But before that it becomes necessary to understand that what is the reason behind such attitude towards a family member who is mentally ill, what is the cause of burden and what all changes the caregivers’ and the patients’ quality of life come across.

Insanity defence in bipolar patients at the time of committing murder according to Iranian law: Case studies

2019 ◽  
Vol 88 (1) ◽  
pp. 24-29
Author(s):  
Azadeh Memarian ◽  
Seyed Hossein Moosavinezhad Baboli ◽  
Hanieh Saboori Shekofteh
Keyword(s):  
Bipolar Disorder ◽  
Social Media ◽  
Public Education ◽  
Forensic Psychiatry ◽  
Legal Responsibility ◽  
Criminal Behaviour ◽  
Iranian Law ◽  
The Family ◽  
Bipolar Patients

Bipolar disorder is a chronic, relapsing illness characterised by recurrent episodes of manic or depressive symptoms, with intervening periods that are relatively (but not fully) symptom-free. Studies have found higher rates of psychiatric disorders in homicide offenders than in the general population. The insanity defence is a legal construct that, under some circumstances, excuses defendants with mental illness from legal responsibility for criminal behaviour. Here we report two cases of family murder by the mother of the family caused by bipolar disease. The role of the forensic psychiatrist in diagnosing insanity during the commission of a crime is very important as these patients should be diagnosed, treated as soon as possible, and monitored. Public education through social media should be considered to reduce crimes in societies. Diagnosing insanity during the commission of a crime is very important and requires high precision forensic psychiatry. Public education through social media should be considered to reduce crimes in societies.

The Importance of the Role of the Patient in the Outcome of Schizophrenia

1993 ◽  
Vol 163 (1) ◽  
pp. 62-68 ◽  
Author(s):  
R. D. Scott ◽  
L. Fagin ◽  
D. Winter
Keyword(s):  
Social Functioning ◽  
Interpersonal Perception ◽  
The Family ◽  
Schizophrenic Patients ◽  
Patterns Of Interaction

The Family Interpersonal Perception Test (FIPT) was used to explore the relationships between schizophrenic patients and their parents, and how these related both to relapse in the year after discharge and to improvement in social functioning. Forty schizophrenic patients and their parents were tested during their first ever admission to hospital and again two years later. Parents' and patient's views of each other were more negative in those with worse outcome, but what most significantly distinguished groups with different outcomes was how patients expected their parents to see them. The FIPT, therefore, reveals patterns of interaction in which the patient's role in outcome is at least as important as that of the parents, and can aid the identification of specific features with which to work in therapy.

scholarly journals Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations

2008 ◽  
Vol 20 (3) ◽  
pp. 881-897 ◽  
Author(s):  
David J. Miklowitz ◽  
Kiki D. Chang
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Childhood Adversity ◽  
At Risk Youth ◽  
Degree Relative ◽  
Course Of Illness ◽  
Psychosocial Impairment ◽  
At Risk Children ◽  
Mood Lability

AbstractThis article examines how bipolar symptoms emerge during development, and the potential role of psychosocial and pharmacological interventions in the prevention of the onset of the disorder. Early signs of bipolarity can be observed among children of bipolar parents and often take the form of subsyndromal presentations (e.g., mood lability, episodic elation or irritability, depression, inattention, and psychosocial impairment). However, many of these early presentations are diagnostically nonspecific. The few studies that have followed at-risk youth into adulthood find developmental discontinuities from childhood to adulthood. Biological markers (e.g., amygdalar volume) may ultimately increase our accuracy in identifying children who later develop bipolar I disorder, but few such markers have been identified. Stress, in the form of childhood adversity or highly conflictual families, is not a diagnostically specific causal agent but does place genetically and biologically vulnerable individuals at risk for a more pernicious course of illness. A preventative family-focused treatment for children with (a) at least one first-degree relative with bipolar disorder and (b) subsyndromal signs of bipolar disorder is described. This model attempts to address the multiple interactions of psychosocial and biological risk factors in the onset and course of bipolar disorder.

Understanding and Management of Caregivers' Stress and Burden of Person with Obsessive Compulsive Disorder

2017 ◽  
pp. 124-142
Author(s):  
Shikha Soni ◽  
Poornima C. ◽  
P. C. Ashfak Ahamed
Keyword(s):  
Mental Illness ◽  
Interpersonal Relationships ◽  
Expressed Emotion ◽  
Family Intervention ◽  
Education Programme ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Care Giving ◽  
The Family

The objective of the chapter is to understand the processes involved in care giving for those with a Chronic Mental Illness and to develop an effective intervention incorporating methods and strategies that aims at reducing caregiver stress and burden. OCD is a neurobiological disorder characterized by the presence of symptoms such as obsessions and compulsions. Literature is reviewed on prevalence, intervention and tools that can assess caregiver stress and burden in OCD. Accommodation and Expressed emotion plays key roles in interpersonal relationships that exist in the families of those afflicted with mental illness and may affect the treatment. Psycho education found to be helpful in educating the family about all the relevant aspects of OCD and to determine their role as a caregiver in order to deal with the illness in an effective way. Family intervention beyond the scope of psycho-education programme is required to prepare caregivers to take on the role of care giving more effectively.

scholarly journals Dementia and family burden of care in Lebanon

2017 ◽  
Vol 14 (1) ◽  
pp. 7-9 ◽  
Author(s):  
Monique Chaaya ◽  
Kieu Phung ◽  
Samir Atweh ◽  
Khalil El Asmar ◽  
Georges Karam ◽  
...  
Keyword(s):  
Psychosocial Interventions ◽  
Well Being ◽  
The Elderly ◽  
Family Carer ◽  
Burden Of Care ◽  
Family Carers ◽  
Arab Region ◽  
The Family ◽  
Mental Well Being

The burden on and mental well-being of family carers for the elderly, especially those with dementia, has been well studied in high-income countries and to a lesser extent in the Arab region. Our study of Lebanese carers highlights the importance of considering the psychological well-being of the family carer, and the role of dementia and depression in increasing the burden of care. Psychosocial interventions have produced equivocal results and therefore customised and contextualised interventions need to be researched. Greater understanding of the coping mechanisms used by carers is required and an examination of the positive aspects of caring is warranted.

Family expressed emotion and drug use in young / Emoción expresada familiar y uso de drogas en jóvenes

2009 ◽  
Vol 9 (2) ◽  
Author(s):  
Juan Antonio Becerra García
Keyword(s):  
Drug Abuse ◽  
Young People ◽  
Drug Use ◽  
Home Environment ◽  
Expressed Emotion ◽  
Climate Factor ◽  
The Family ◽  
Sobre Todo

La familia es el principal agente de riesgo y protección de uso de droga a edades tempranas, sobre todo el factor de clima emocional familiar. La emoción expresada (EE) es un concepto que refleja la atmósfera emocional del hogar. Los componentes específicos de la EE, crítica, hostilidad y sobreimplicación emocional, son predictores importantes de recaída en diferentes patologías y en el abuso de drogas. El objetivo principal de este trabajo es describir la EE y examinar el papel del concepto en el uso de droga en jóvenes. En conclusión, la EE es una medida relevante, que necesita ser evaluada, en el uso de droga en jóvenes.Absctract The family is the main agent of risk and protection of drug use at younger ages, especially the family emocional climate factor. Expressed emotion (EE) is a concept reflecting the emotional atmosphere of the home environment. Specific components of EE, criticism, hostility and emotional over-involvement, they are important predictors of relapse in different pathologies and drug abuse. The main aim of this work is to describe the EE and examine the role of the concept in drug use in young people. In conclusion, the EE is a relevant measure, which needs to be evaluated, in drug use at young ages.

Why Latinas With Breast Cancer Select Specific Informal Caregivers to Participate With Them in Psychosocial Interventions

2016 ◽  
Vol 28 (4) ◽  
pp. 391-397 ◽  
Author(s):  
Terry Badger ◽  
Chris Segrin ◽  
Paulina Swiatkowski ◽  
Melissa McNelis ◽  
Karen Weihs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Emotional Support ◽  
Informal Caregiver ◽  
Psychosocial Interventions ◽  
Cultural Value ◽  
Baseline Assessment ◽  
Health Crisis ◽  
Psychosocial Services ◽  
The Family

The purpose of this study is to describe the reasons 88 Latinas with breast cancer selected specific supportive others to participate in an 8-week psychosocial intervention. Participants were asked one open-ended question during the baseline assessment for a larger clinical trial: “Could you tell me more about why you selected [insert name] to participate in the study with you?” A content analysis of the responses found three thematic categories: source of informational or emotional support, concern for the informal caregiver’s welfare, and special characteristics or qualities of the informal caregiver. These findings reflected both the cultural value of familism, the woman’s role as caregiver to the family ( marianismo), and the man’s role of provider ( machismo). Findings provide support for including the supportive person identified by the patient during a health crisis rather than the provider suggesting who that should be. Psychosocial services designed and implemented through such a cultural lens are more likely to be successful.

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