[Mental disorders in severely dysfunctional and in well-functioning families]

The types of mental disorders and their prevalence in severely dysfunctional (SD) and well-functioning (WF) families were compared. SD families were characterized by chronic conflicts, absence of closeness and lack of trust between parents, and bad relations and lack of support between parents and their children. WF families were characterized by high levels of psychological intimacy, warm and satisfying relationships between parents and children, and a warm, affectionate, optimistic family mood. 23 SD families (44 parents and 60 children) and 61 WF families (121 parents and 184 children) were followed for over 4 years by the author of this study. There was a high prevalence of mental disorders in parents of SD families in comparison to the WF families (43.2% vs 6.6%). This excess was significantly less in men (p = 0.05), in whom the risk ratio was 3.3 (p = 0.03), while for women it was 10.2 (p less than 0.0001). Most prominent was the higher prevalence of chronic anxiety: 25% vs 5% with a risk ratio for men of 2.9 (p = 0.09), and for women 7.1 (p less than 0.0001). Among children as well, there was greater prevalence of psychiatric illness in SD families--56.6% vs 3.8%, risk ratio 14.9 (p less than 0.0001). The prevalence of developmental speech and language disorders in SD families was 33.2 times greater, of hyperkinetic syndrome 12.3 times, and of enuresis 7.2 times. In contrast to the parents, the overall rate of illness was not significantly different between the sexes. We feel that it is important to discover such families because treatment and intervention early in childhood may increase the effectiveness of treatment.