Family burden and participation in care: differences between relatives of patients admitted to psychiatric care for the first time and relatives of re-admitted patients.

: Studies on emotional and physical strain imposed on family members in connection with their responsibility of caring for a person with a severe mental illness have focused on the chronic patients. The situation of family members with patients who are at an early stage of illness and admitted for the first time may illuminate different patterns. In this Swedish multi-centre study, 162 relatives of patients in acute psychiatric wards, both those admitted for the first time and those re-admitted, were interviewed concerning their experience of family burden and their participation in care. There were relatively few differences found in burden measures and participation in care between the two subgroups of relatives. However, relatives who were in a career of being a relative to a person with severe mental illness earlier, more often viewed the psychiatric services to be of good quality, although they had had less contact with the staff of the psychiatric services during the last year. The relatives of re-admitted patients experience more often psychological aspects of burden, equivalent to associated stigma. The future task of maintaining the relatives' good opinion of psychiatric services, as well as the issue of giving informationare discussed.