Factors Affecting the Family Attitude Toward the Outpatients With Schizophrenia

Objectives: To identify various factors that might affect a high expressed emotion recognized by primary caregivers of the schizophrenic outpatients.Methods: Of patients who had been receiving outpatient treatments at department of psychiatry of Dong-A university hospital, 154 patients with a DSM-V diagnosis of schizophrenia with stable symptoms and their primary caregivers were enrolled in this study. Family attitude (family attitude scale) was assessed through an interview with primary caregivers. In these patients, symptoms (brief psychiatric rating scale), problem behavior (behavior and symptom identification scale), general health status (shortform 36 health survey), recovery (recovery assessment scale), drug attitude (drug attitude inventory), insight (self-appraisal of illness questionnaire) were assessed through a self reporting questionnaire. Multiple regression analysis were performed in consideration of 15 factors (age, sex, the level of education, marital status, job status, age of onset, duration of illness, number of hospitalization, chlorpromazine equivalent dose, symptoms, problem behavior, general health status, recovery, drug attitude, insight) as explanatory variables for a family attitude.Results: On a multiple regression analysis, the following five factors were found to be significant explanatory variables for a family attitude that is experienced by primary caregivers of the schizophrenic outpatients: job status, duration of illness, number of hospitalization, problem behavior, and drug attitude. A coefficient of determination for these five explanatory variables was 0.58. The high expressed emotion group had significantly higher number of hospitalizations and problem behavior, but lower employment, poorer genral health status, negative drug attitude, and lack of insight compared to the low expressed emotion group.Conclusion: Our results showed that five factors such as job status, duration of illness, number of hospitalization, problem behavior, and drug attitude were found to be significant explanatory variables for family attitude that is experience by primary caregivers of the schizophrenic outpatients. Because these five variables account for 58% of total family attitude, however, further studies are needed to identify other factors that might affect a family attitude.