Tennakoon et al (Reference Tennakoon, Fannon and Doku2000) stated that their study is ‘one of the first’ to investigate burden among caregivers of people with first-episode psychosis. Their paper was published 13 years after our paper which covered much the same ground (The Scottish Schizophrenia Research Group, 1987) and which they did not mention.

We found, using the General Health Questionnaire (GHQ), that 24 (77%) of 31 main caregivers were categorised as ‘psychiatric cases’; this compares with 12% of caregivers in the Tennakoon et al study, which also used the GHQ. However, the relatives in our study were interviewed during the first week of the patients' first admission to hospital, and before the patients received antipsychotic medication. Tennakoon et al's patients could have been ill for up to 2 years and received up to 12 weeks of antipsychotic drugs — hardly ‘first-episode’.

In our 5-year follow-up study (The Scottish Schizophrenia Research Group, 1992), 14 of the 19 relatives who were still living with the patient were reassessed; 6 (43%) were still categorised as ‘cases’, using the GHQ. We concluded that a patient's illness had a considerable and continuing effect on his or her relatives.