[Schizophrenia and the family: difficulties, burdens, emotions, needs]

Treating patients with schizophrenia mostly in the community causes more problems for the families. Shame, guilt, fear, helplessness, hopelessness, and anger are feelings frequently experienced by families. The main difficulties are financial problems, intra-familial conflicts, negative effects on social life, and the rejecting attitude of the community towards the patients. Negative symptoms are especially burdensome for the families. Families with inadequate social support, with high expressed emotion, and who cannot use effective coping styles have heavier burdens. When the relationship between schizophrenia and family is investigated in a historical context, it is seen that most investigators supporting psychological theory consider the family to be the cause of the disease. These theories, which depend mostly on clinical observations and which have damaged the relationship between the clinicians and the family members, have lost their validity during the last thirty years. Family should be included in the treatment plan. Hospitalization due to the first psychotic episode or further psychotic recurrences is the most convenient period for establishing contact with the families. One should approach the family in a supportive and empathic manner, without putting any blame on them. If maladaptive coping styles are being used, one should help the family to change to adaptive ones. In addition to educative and supportive groups, more specific methods like cognitive-behavioral therapies can be used. Families should be supported in terms of forming non-governmental organizations.