Families and mental disorders: From burden to empowerment.
Author: Sartorius, N., Leff, J., Lopez Ibor, J.J., Maj, M., Okasha, A.
Source:
New York, NY, US: John Wiley & Sons Ltd (2005) x, 299 pp.
This volume portrays what is defined in one of its chapters "the journey of families from burden to empowerment", currently ongoing in several countries of the world. An overview is provided of the various dimensions of family burden, as well as of the possible positive consequences of caring for a person with a severe mental disorder, in terms of development of personal attitudes and skills, increase of self-confidence and strengthening of family bonds. The variables which modulate family burden (with a special focus on relatives' coping strategies, appraisal and illness perception) are described. Family-based interventions available for the various mental disorders are reviewed, including the evidence of their effectiveness, the barriers to their implementation and the methodological problems of the relevant research. The recent achievements of family organizations in developed as well as developing countries are outlined. A distinctive feature of the volume is its focus on all the most prevalent mental disorders, including those--such as anxiety disorders, eating disorders and childhood mental disorders--which have been rarely considered in this specific context. Substance abuse, a remarkably neglected area as far as family problems are concerned, is also covered. The presence in a family of a person with a severe mental disorder is often associated with a significant objective and subjective burden on the other family members, especially those who have a caregiving role. The entity of this burden depends on several factors, including the relative's age and gender, the quality of his/her premorbid relationship with the patient, the nature of the patient's problems, the coping strategies adopted by the relative as well as his/her appraisal of the situation and perception of the patient's illness, the emotional and practical support available to the family, and cultural and ethnic variables. An important component of the family burden are the consequences of the stigma attached to mental illness: stigma does not stop at those who are close to the patient; it extends across generations and reaches far away parts of families. The burden experienced by the family members may not only affect their own mental and physical well-being, but also have an impact on the course of the patient's disorder (well documented especially in the case of schizophrenia).