[Different approaches to the concept of family burden in schizophrenia]

This paper explores selected theoretical and experimental issues related to the notion of burden. The burden is a phenomenon which appears not only inside families with diagnosed schizophrenia but also in families of people presenting a different kind of psychic disorder or those being mentally handicapped. Using the term "family burden" is not usually followed by such operationalization of the notion, that would unable its investigation in the family system. Research does not say which sociodemographic and psychosocial factors have a decisive impact on the level of the noticeable burden. It seems, however, that a minor role should be attributed now to sociodemographic factors, while methods of overcoming the problems are the most significant. Findings let us think that objective factors composing the burden are individually judged by care givers who work with people with psychic disorders. This evaluation decides how important a specific factor is. This situation makes us reconsider the traditional division of the objective and subjective burden. The symptoms that might be noticed with the patients are not the only predictors of the burden. The source of care givers' burden is not directly connected with the psychopathological symptoms but rather with a deficit in a patient's sphere of functioning. While analysing the burden inside families of patients with psychic disorders it should be remembered that the reason can be not only problems related directly to the illness but also a number of unspecific factors saddling the family like unemployment, poor living conditions, difficulties at work, at school etc. Findings presented in this article disclose a poor precision of existing burden definitions resulting from a lack of a consistent conception of this phenomenon. The author attracts our attention to socio-cultural conditioning of the burden and shows how people with mental disorders positively contribute to family life. Nowadays the classical concept of the burden is more often replaced by stress management models. In the conclusion the author points out that the research on burden conducted so far is rather insufficient.