Indicators of Social Functioning Affecting Intrafamily Relationships in Patients with Neurotic Spectrum Disorders

Background: the problem of studying certain aspects of the quality of life of patients with mental disorders, including the neurotic spectrum, remains insufficiently disclosed. The level of quality of life is influenced by various factors, one of which is the nature of intra-family relationships, which largely depends on the indicators of social functioning.

The aim was to identify and analyze indicators of social functioning that undergo changes against the background of the development of neurotic spectrum disorders and have an impact on intra-family relationships.

Patients and Methods: a simultaneous prospective comparative study of individual aspects of social functioning affecting family relationships of patients with neurotic spectrum disorders before and after the development of neurotic pathology was conducted. The research material was data from an anonymous voluntary survey of 500 patients with diagnoses according to the International Classification of Diseases 10th revision (ICD-10) — F40–F48; F32; F06. A specially designed questionnaire was used, which included blocks for assessing family status, work, financial situation, fear of stigmatization, and the specifics of seeking specialized help.

Results: against the background of the development of a neurotic mental disorder, the divorce rate increased 3-fold, and the level of conflict in families increased significantly. The deterioration of the financial situation due to the forced transition to a job with a lower salary was subjectively associated with an increase in the number of family conflicts in 69.4% of cases. A pronounced fear of intra-family stigmatization was noted by 31.2% of patients, while external stigmatization was noted by 39.6%. More than a third of patients (36%) first sought specialized psychiatric help only 2 years or more after the onset of the disease. One of the main reasons of late referral was the fear of stigmatization due to their disorder.

Conclusion: indicators of social functioning such as marital status, financial status, and fear of stigmatization of an existing neurotic disorder show significant dynamics and are closely related to the nature of intra-family relationships in patients with neurotic spectrum disorders. Studying the specific effects of neurotic spectrum disorders is important for developing an integrated approach to therapy and rehabilitation.

1. Neznanov NG, Rukavishnikov GV, Kaysanov ED, Philippov DS, Kibitov AO, Mazo GE. Biopsychosocial model in psychiatry as an optimal paradigm for relevant biomedical research. V.M. Bekhterev review of psychiatry and medical psychology. 2020;(2):3–15. (In Russ.). doi: 10.31363/2313-7053-2020-2-3-15

2. Grigorieva EV. Patient social function and quality of life in schizophrenia: focus on paliperidone palmitate. V.M. Bekhterev review of psychiatry and medical psychology. 2017;(1):59–62. (In Russ.).

3. Tselischev DV, Stanich S. Quality of life and satisfaction with medical care in patients with mental disorders of the schizophrenic spectrum. S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(1–2):26–34. (In Russ.). doi: 10.17116/jnevro202212201226

4. Høegh MC, Melle I, Aminoff SR, Olsen SH, Lunding SH, Ueland T, Lagerberg TV. Affective lability and social functioning in severe mental disorders. Eur Arch Psychiatry Clin Neurosci. 2022;272(5):873–885. doi: 10.1007/s00406-022-01380-1

5. Clausen H, Ruud T. The Practical and Social Functioning (PSF) scale: development and measurement properties of an instrument for assessing activity and social participation among people with serious mental illness. BMC Psychiatry. 2024;24(1):693. doi: 10.1186/s12888-024-06135-x

6. Proschenko IV, Maximova NE, Murasheva LA, Ulyanova EV. Research study of quality of life of patients with chronic mental disorders. Social and Clinical Psychiatry. 2020;30(2):37–41. (In Russ.).

7. Khamitov RR, Romanova AP. Social functioning and quality of life of women with mental disorders who committed serious offences against the person and undergoing compulsory treatment under conditions of intensive observation. Neurology Bulletin. Named after V.M. Bekhterev 2019;LI(1):84–90. (In Russ.) doi: 10.17816/nb13567

8. Redko AN, Kosenko VG, Kosenko NA, Pashchenko IE, Pogodina MG, Shulkin LM, Ageev MI, Skubak AA. Sociodemographic and clinical features of persons with mental disorders who apply to non-governmental medical institutions in the period before the COVID-19 pandemic and the first year of its course (2019–2020). Social and Clinical Psychiatry. 2022;32(1):74–81. (In Russ.)

9. Yastrebova VV, Solokhina ТA. Clinical, social and psychological aspects of rehabilitation work in public organization: evaluation of effectiveness. Psychiatry (Moscow) (Psikhiatriya). 2018;(79):51–60. (In Russ.). doi: 10.30629/2618-6667-2018-79-51-60

10. Tselishchev DV. Quality of life of outpatients with mental disorders. Social and Clinical Psychiatry. 2022;32(3):44–48. (In Russ.).

11. Rudenko SL. Quality of Life and Social Perception in Patients with Hysterical Neurosis. SibScript. 2023;25(5):625–634. (In Russ.). doi: 10.21603/sibscript-2023-25-5-625-634

12. Kupriyanova IE. Clinical dynamics and quality of life in patients with neurotic disorders. Medical Psychology in Russia. 2014;2(25):[Electronic resource]. (In Russ.).

13. Novik AA, Ionova TI. Guide to the Study of Quality of Life in Medicine. Edited by Yu.L. Shevchenko. Moskow. RANS. 2021:664. (In Russ.).

14. Demcheva NK, Korol IS. Clinical and dynamic characteristics of psychic disorders and the quality of life of disabled people due to mental illness. Russian Journal of Psychiatry. 2010;(2):14–21. (In Russ.).

15. Oshevsky DS, Solokhina TA. Evolution of Approaches to Understanding Functional Diagnosis in Psychiatry: From Theoretical Conceptualization to Practical Using. Psychiatry (Moscow) (Psikhiatriya). 2023;21(4):103–119. (In Russ.). doi: 10.30629/2618-6667-2023-21-4-103-119

16. Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am J Psychiat. 1997;154(1):99–105. doi: 10.1176/ajp.154.1.99

17. Getmanenko Ya.A., Trusova AV, Dobrovol'skaya A.E., Sofronov AG. (2019). The influence of family system and individual psychological characteristics of the caregiver on the effectiveness of socio-psychological adaptation in patients with schizophrenia. National Psychological Journal. 2019;(12)3:101–112. (In Russ.). doi: 10.11621/npj.2019.0311

18. Filimonov AP, Volodin BY. The quality of life of patients with mental disorders. I.P. Pavlov Russian Medical Biological Herald. 2011;19(2):24–24. (In Russ.).

19. Lutova NB, Makarevich OV, Sorokin MYu, Novikova KE, Abramchic SS, Vid VD. Psychiatric stigma: clinical, demographic or cultural factors. Social and Clinical Psychiatry. 2019;29(4):50–56. (In Russ.).

20. Lutova NB, Makarevich OV, Sorokin MYu. Family burden and self-stigma of schizophrenic patients' relatives. Social and Clinical Psychiatry. 2020;30(4):22– 27. (In Russ.).

21. Lutova NB, Makarevich OV. Internal stigma features at relatives of psychotic patients. V.M. Bekhterev review of psychiatry and medical psychology. 2020;(4):42–49. (In Russ.). doi: 10.31363/2313-7053-2020-4-42-49

22. Khritinin DF, Nekrasov MA. The influence of mental disease on the family environment of the patient: results of the sociological questioning. S.S. Korsakov Journal of Neurology and Psychiatry. 2013;113(9):75-78. (In Russ.).

23. Lutova NB, Makarevich OV. Objective and subjective family burden: correlations with demographic and clinical features of schizophrenic patients. Social and Clinical Psychiatry. 2021;31(4):21–28. (In Russ.).

24. Kiryanova EM, Salnikova LI. Psychiatric patients' social functioning and quality of life as an important indicator of mental health care effectiveness. Social and Clinical Psychiatry. 2010;20(3):73–75. (In Russ.).

25. Kosenko VG, Alekseenko SN, Redko AN, Kolomiets EA, Kosenko NA. Clinical, social and medical-demographic characteristics of fertility in families of patients with endogenous mental pathology living in urban and rural areas. Russian Journal of Psychiatry. 2024;(1):37–44. (In Russ.).