BACKGROUND: The aim of the present study was to investigate whether dysfunctional family functioning contributes to relapse over a two-year follow-up period in @entity1 experiencing their first episode of @entity716 (FEP) and chronic @entity1 with @entity716 . METHODS: The sample consisted of 100 remitted @entity1 (50 FEP and 50 chronic) diagnosed with @entity161 (82%) or @entity162 with most recent episode manic severe with @entity716 features (18%) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), @entity5785 (FQ), family burden ( @entity4434 ) and caregivers' @entity458 (GHQ-28). Relapse was defined as @entity1 rehospitalisation due to acute @entity716 exacerbation, while number, length, and type of hospitalisations were also evaluated. RESULTS: Dysfunctional family functioning in terms of cohesion and flexibility was not found to be a significant risk factor for relapse in @entity716 . High @entity5785 , as indexed primarily by increased levels of criticism rather than emotional over-involvement, was associated with increased risk of relapse and shorter time to relapse (HR=0.48, 95% CI: 0.24, 0.98, p=0.043). Similarly, high levels of family burden were related to shorter time to relapse (HR=0.47, 95% CI: 0.23, 0.95, p=0.037), whereas there was no significant difference in survival curves based on caregivers' @entity458 . No significant interaction effect of illness chronicity was observed in the aforementioned associations. CONCLUSION: These findings highlight caregivers' criticism and burden of care as long-term predictors of the course of @entity716 from the early stages of the illness and later on. In contrast, unbalanced levels of cohesion and flexibility in the family, as well as caregivers' high emotional over-involvement and @entity458 do not appear to be factors that contribute to @entity1 relapse. Family psychoeducational interventions focusing at ameliorating caregivers' negativity toward the @entity1 , and easing the burden of care should be considered as means in reducing relapse.

Impaired family functioning in XXXX and its relevance to relapse: a two-year follow-up study.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity162 :: ('MESH:D001714', 'Disease') :: ['bipolar disorder'] @entity5785 :: ('MESH:D001039', 'Disease') :: ['expressed emotion'] @entity458 :: ('MESH:D020018', 'Disease') :: ['psychological distress'] @entity161 :: ('MESH:D012559', 'Disease') :: ['schizophrenia'] @entity716 :: ('MESH:D011605', 'Disease') :: ['psychotic', 'psychosis'] @entity4434 :: ('MESH:D005198', 'Disease') :: ['FBS']
@entity716 :: (MESH:D011605,Disease) :: ['psychosis']
