THE ROLE OF INTERPERSONAL FACTORS ON COURSE AND TREATMENT OF MENTAL AND SOMATIC DISORDERS

In this paper the role of familial and marital variables for the etiology, course and treatment of selected mental and somatic disorders is discussed. The results of the research on ''expressed emotion'' indicate that family factors - in particular a critical attitude towards the patient and emotional over-involvement - partly determine whether schizophrenic patients or patients with an affective disorder will relapse 9 months after discharge from hospital. Based on these findings and on the vulnerability-stress model, several psychoeducational programs have been developed which effectively reduce the relapse in schizophrenic patients. The quality of the marital relationship has been linked to a wide range of adult and child disorders. Recently, associations have been found between marital communication variables and psychophysiological, psychoneuroendocrinological and psychoimmunological parameters indicating that marital conflict may be a generic risk factor for the onset as well as the course of disorders. Therefore the primary prevention of marital distress seems to be valuable in order to reduce the risk of developing health problems. The results of recent longitudinal studies clearly demonstrate the effectiveness of these programs to prevent marital distress. Future research should incorporate older, already married couples in order to test the effectiveness of these approaches to prevent health problems.