The purpose of this study was to describe the relationship of chronicity in a Japanese schizophrenic population to family/patient interaction. Chronicity was conceptualized as consisting of duration and disability. A chronicity score was created by adding the z-score of duration to the z-score of disability. Family/patient interaction was conceptualized as consisting of family support, family rejection, and family burden.

The total sample size was 71, and data from 67 patients, 68 families, and 71 primary nurses were obtained. Data were collected by the Level of Rehabilitation Scale, and Dependency Dimension Scale in the AMAE Network Questionnaire, the Family Cooperation Scale, the Patient Rejection Scale, and the Family Burden Scale. Data were analyzed by correlation analysis, step-wise regression, and factor analysis.

There were six significant findings: (a) the patient's and the nurses' perception of family support were related differently to chronicity, family rejection, and family burden; (b) the operationalization of chronicity was validated; (c) the patient's perception of family support was the most powerful variable for chronicity; (d) family rejection was related to chronicity; and (e) family burden was not related to chronicity; and (f) the patient's perception of family support was not related to family rejection and family burden.

This study supports the assumption that chronicity arises from the family/patient interaction. Chronicity is related to both family support as perceived by the patient and to family rejection. Family support seems to influence chronicity, while family rejection seems to be the result rather than the product of chronicity. Positive family/patient interaction, as perceived by the patient, has little relationship to negative family/patient interaction, as perceived by the family.

These study findings suggest that (a) the patient's age and competence influence the relationship between chronicity and family/patient interaction; (b) family rejection might be better conceptualized by distinguishing between the feeling and the action of rejection; and (c) family burden might be better conceptualized as consisting not only of two components, subjective and objective burden, but also of two causes, providing care for and rejecting the patient.