Siblings of schizophrenic patients - A review

The families of patients with schizophrenia carry an enormous emotional and social burden. This article is a historical review of the study of the wel l siblings of schizophrenic individuals. The early investigations (1950s-19 70s) were based on the theory of familial transmission of schizophrenia and focused on siblings from the aspect of their susceptibility to the disease . Many claimed that even siblings who did not develop full blown schizophre nia still suffered from considerable psychiatric disorders that were attrib utable to pathological familial psychodynamics. Case control studies were u sed to explain how some well siblings "escaped" the pathological family net work. With the introduction of the concept of family burden in the late 196 0s, research shifted to the emotional impact of growing up with a schizophr enic brother or sister. This was accompanied by the emergence of self-help groups and published case histories of siblings themselves. In the early 19 80s, the data were essentially descriptive. Investigators studied sibling s hame, poor self-esteem and feelings of stigmatization. Different patterns o f coping with the subjective burden were distinguished More recently, great er efforts have been made to systematically define the variables associated with the burden experienced by siblings. To answer the many still outstand ing questions, further studies are needed based on a longitudinal design an d homogeneous samples. For example: Are sibling's personal relationships ou tside the family affected? Does the sibling place within the family affect his or her reaction to the sick brother or sister? Does guilt play a role? What type of intervention is needed? With the increasing role of the commun ity in the management of the mentally ill, such research has become very im portant.