We usually view a family as small social group, with its basic characteristics to be mutual co-operation of all of its individual members. They are inter-connected by a variety of relations. As each member of a family is an individual and original personality, even the created family makes an individual, original and unrepeatable social organism. This applies to each different family {--} even to families with a handicapped child. This is to say, coexistence in one or another family has the same basic characteristics. When talking of life quality of people, we may have in mind different extent of perception of a man. It is possible to talk about life quality of an individual man as well as life quality of several people, e.g. life quality in a family. The aim of the graduation thesis was to find out the life quality of families living with an individual with slight mental disorder (IQ 50-60). To find out their difference from families without any mentally handicapped individual. All of that using the PedsQL questionnaire, which is a sufficient criterion for the problems fixation. Information needed for the graduation thesis processing was obtained on the basis of specialised material studies. Quantity research was performed to map the families life quality. Data collection was performed using the questioning method {--} the questionnaire method. The questionnaire designed by James Walter Varni Ph.D. was distributed to two groups {--} families with a slightly mentally handicapped individual (IQ 50-69) and families with children, without any mentally handicapped individual. The questionnaire contained 8 areas, in which the individual families could encounter any problem. The aim of the graduation thesis was fulfilled and the research confirmed the hypothesis that life quality of a family with slightly mentally handicapped individual with his/her intelligence quotient in the range of 50-60 points, differs from life quality of a family without any mentally handicapped individual. Some questions of the questionnaire provably demonstrated lower quality of life in families living with a slightly mentally handicapped individual.

The term “mental health” is everywhere, from government agendas, to educational reforms, to daily discourse. This is for good reason—hundreds of millions of people suffer from significant mental health concerns with a diagnosable mental disorder, let alone the fact that nearly all individuals have struggled with their mental health. The importance of mental health is uncontroversial, but the same cannot be said about its nature. Every practice related to mental health—which involves some of the most vulnerable people in the world—is committed to a conceptualization of mental health regardless of whether that practice is cognizant of this fact. Therefore, it is imperative to develop better answers to the questions of “what is mental health and why?” because conceptualizations of mental health systematically guide research, intervention, policy, and even how individuals strive to live their lives. I argue that the answer to the question of “what is mental health?” is that mental health is a causal nexus of positive facts. That is, mental health is to be identified with a cluster of positive facts that regularly co-occur such as resilience, hedonistic mental states like joy, high cognitive functioning like concentration, and productivity. The answer to the question “why is mental health what it is?” is that the positive facts regularly appear together due to the causal relations between them, rather than arbitrarily. For instance, resilience causes high cognitive functioning, which in turn causes resilience, which causes productivity, which causes high cognitive functioning and joy, and so forth. This explains why mental health is what it is because the causal relations between positive facts “glue” them together, causing them to regularly co-occur, thereby making them a stable category of existence that factors into epistemic practices such as induction and prediction. However, given the state of our knowledge, further empirical evidence is needed to elucidate the exact positive facts that constitute the mental health causal nexus and thus answer what mental health is. I provide a novel methodology—the anchoring analysis—that involves studying the mechanisms of causal interactions between potential positive facts to determine which are the most causally important and thus should be considered constitutive facts of mental health. Elucidating the homeostatic mechanism of the kind mental health is a daunting task; however, we only complicate matters for ourselves if we simplify the complexity of mental health. / Thesis / Candidate in Philosophy

Introduction The aims of this thesis were twofold. The first was to systematically review the literature, on the influence of childhood trauma on psychopathology, across a range of forensic settings. The second was to complete an empirical study that examined the relationship between childhood trauma and insecure attachment patterns and psychopathology, risk, and engagement in therapy, in a forensic population. Method For the first aim database searches and hand searches of journals assessed against predefined criteria, identified 13 papers that were eligible for review. For the research study, 64 participants from three forensic secure hospitals completed three self-report questionnaires as part of a retrospective cross-sectional design. Data was also obtained from hospital records and clinical staff. Results The systematic review identified ten studies that were rated to be of good quality, two that were rated to be of fair quality and one that was rated as weak. Results identified a relationship between childhood trauma and psychopathology, but it is difficult to generalise findings due to the heterogeneity of this population. The research study found both childhood trauma and insecure attachment significantly predicted psychopathology and risk. No associations with engagement in therapy were found, but methodological reasons for this outcome were considered. Conclusion The systematic review highlighted that research in the area of childhood trauma and psychopathology in forensic settings is at an early stage, as most studies are small and cross-sectional. It discussed the need to develop further research to improve psychological treatment and reduce recidivism. Recommendations were made in the research study to routinely assess for childhood trauma and consider attachment patterns. Limitations in the design of the study were also acknowledged.

Attention Deficit/Hyperactivity Disorder has garnered controversy in the United States since it became a widely diagnosed disorder in American schoolchildren in the 1970s. Both diagnosis and treatment are sites of controversy. Some believe the disorder is a contrivance of parents and teachers who do not want to deal with hardly exceptional childhood difficulties, or a contrivance of pharmaceutical companies taking advantage of such parents and teachers. Others believe that a neurobiological basis for the disorder will eventually be discovered, and thus will legitimize both the diagnosis and the practice of prescribing medication for treatment. I utilize the Science, Technology, and Society approach of actor network theory to show that these multiple understandings of ADHD can coexist, since ADHD is a complex product of external and internal agents. This will demonstrate how cultural shifts and values cause parents, teachers, and doctors to evaluate childhood in a way that frames certain behaviors as harmful. I also evaluate how cultural values of medicalization center issues in the individual rather than in external factors, and assess the values that psychiatric treatment appeals to and whether they primarily serve the needs of children. I conclude that ADHD is a heavily context-dependent disorder, but that that does not delegitimize harmful effect on children who exhibit ADHD-associated behaviors. I also conclude that the current dominant medicalized approach to ADHD is not optimal because it focuses on only a few of the total factors that make ADHD a pathological disorder for children in the contemporary United States.

Syftet med detta examensarbete var att beskriva behandlares attityder och uppfattningar om Kultur på recept som rehabiliteringsmetod för patienter med lättare till medelsvår psykisk ohälsa och/eller ospecificerad långvarig smärta. Metoden var en kvantitativ enkätstudie. Enkäten distribuerades digitalt till 89 behandlare inom primärvården, med möjlighet att remittera till Kultur på recept, och besvarades av 32, vilket innebar att bortfallet bestod av 57 personer. Insamlad data bearbetades med deskriptiv och jämförande statistik med hjälp av statistikprogrammet Package for the Social Sciences [SPSS], version 21. Resultatet visade att Kultur på recept framförallt ansågs ha effekt för ökad subjektiv hälsa och symptomlindring. Respondenternas kunskapsnivå visade sig ha betydelse för hur effektiv behandlingsmetoden uppfattades och i vilken grad de föreslog denna. Resultatet visade också att kvinnor erbjöds Kultur på recept i större omfattning än män. Framförallt berodde det på, enligt respondenterna, att kvinnor är sjukskrivna i högre grad än män för framförallt psykisk ohälsa men även långvarig smärta. Några uttryckte även att intresset för kulturella aktiviteter var större hos kvinnor.  Slutsatsen är att det är viktigt att behandlare har kunskap om Kultur på recept för att uppfatta behandlingsformen som effektiv och vilja remittera till den. Det är också viktigt att föra diskussioner om genusperspektiv hos behandlare som kan påverka valet av rehabilitering, samt att vid sammansättningen av Kultur på recept ha med en variation av aktiviteter som kan tilltala olika intresseinriktningar hos både män och kvinnor. / The aim of this thesis was to describe healthcare professionals’ attitudes and perceptions of Arts on prescription as a rehabilitation method for patients with mild to moderate mental illness and/or unspecific longterm pain. The method was a quantitative survey. The survey was distributed digitally to 89 primary care professionals, able to prescribe Arts on prescription, and 32 responded. The non-response was 57 persons. The collected data were analysed using descriptive and comparative statistics using the Package for the Social Sciences [SPSS], version 21. The results showed that the method of treatment primarily had effect on increased subjective health and symptom relief. The respondents' level of knowledge also proved to be important for the perceived effectiveness of the method of treatment, and to the extent to which the respondents proposed it. The result also showed that women were offered Arts on prescription to a greater extent than men. In particular, it was reported, according to the respondents, that women were on sick-leave to a greater extent than men, especially due to mental illness, but also due to longterm pain. Some respondents also meant that women have a greater interest in cultural activities. The conclusion was that it was important for therapists have good knowledge of Arts on prescription, in order to perceive the treatment as effective, and show willingness to prescribe it. It is also important with further discussions on gender perspectives among therapists which can influence the choice of rehabilitation, and in the composition of Arts on prescription, include a variety of activities that might address different interests of both men and women.

The aim of this thesis is to assess the Czech legislation in legal actions of persons suffering from mental disorder. The thesis is composed of five chapters. The first chapter describes the historical background of the topic. In the second chapter I describe in detail basic terms such as legal action, legal capacity and mental disorder, since these are important and essential for the thesis. The fundamental part of the thesis discusses institutes that support the legal conduct of persons suffering from mental disorder. These are preliminary statement, assist in determining, the representation of a household member, incapacitation and limitations associated with the institute guardian. The final chapter describes the fundamental international legal documents that influenced the Czech legislation.

Introdução: Dentre as diferentes manifestações de saúde que acometem os idosos, pode-se destacar os Transtornos Mentais Comuns (TMC). Sugere-se que a adesão a padrões alimentares específicos, como a dieta MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), possa atenuar ou reduzir os riscos relacionados ao envelhecimento. A Dieta MIND tem como princípio ingestão elevada de frutas vermelhas, vegetais verdes folhosos e demais vegetais, aves, peixes, oleaginosas, leguminosas, grãos integrais, azeite de oliva extra-virgem, vinho tinto, e por sua vez, uma ingestão baixa de carnes vermelhas, doces e massas, queijos, manteiga, margarina, além dos alimentos convencionalmente chamados de \"fast food\". Objetivo: este estudo tem como objetivo identificar, em idosos, a pontuação do padrão dietético MIND e investigar a associação entre essa pontuação e a presença de TMC. Métodos: a amostra para o presente estudo é derivada do Inquérito de Saúde - ISA Capital Nutrição, no período de 2015. Foram estudados, nessa amostra, 545 idosos (acima de 60 anos), de ambos os sexos. Os dados alimentares da amostra foram obtidos a partir de dois recordatórios alimentares de 24 horas, que foram corrigidos para identificação da dieta habitual, e calculados quanto à ingestão dos grupos alimentares que constituem a dieta MIND. Além disso, a pontuação à dieta MIND foi identificada a partir da mediana da ingestão dos grupos determinados. A presença de TMC foi avaliada por meio da aplicação do SRQ-20 (Self-Reported Questionnaire). Foram ainda consideradas algumas variáveis de ajuste (sexo, idade, raça, nível de atividade física de lazer, presença de doenças crônicas como hipertensão arterial sistêmica, dislipidemia e diabetes mellitus, renda familiar total, Índice de Massa Corporal e escolaridade). Resultados: os participantes avaliados eram em sua maioria mulheres, inativas, com presença de doenças crônicas. Não houve associação significativa quanto a adesão à pontuação da dieta MIND e TMC, contudo, alguns componentes da dieta, quando associados isolados, mostraram associação significativa e protetora (vegetais verdes folhosos, outros vegetais não folhosos e leguminosas). Por sua vez, o consumo de carnes vermelhas mostrou correlação negativa para TMC. Conclusão: O presente estudo não encontrou associação significativa entre a pontuação 7 da dieta MIND e TMC entre os idosos, entretanto, quando se analisou os componentes do padrão dietético MIND isolados em relação a TMC, encontrou-se correlação positiva para os grupos de vegetais verdes folhosos, outros vegetais e leguminosas e correlação negativa para o grupo de carnes vermelhas. Desse modo, estratégias nutricionais voltadas à saúde da função cerebral, com foco em um maior consumo de alimentos protetores e menor consumo de alimentos não-protetores presentes na dieta MIND, podem auxiliar beneficamente a população, especialmente os idosos. / Introduction: Among the different health manifestations that affect the elderly, we can highlight Common Mental Disorders (CMD). In turn, it is suggested that adherence to specific dietary patterns, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay, may attenuate or prevent mental disorders related to aging. The MIND Diet has as a principle a relatively high intake of healthy foods such as red fruits, leafy green vegetables and other vegetables, poultry, fish, oilseeds, legumes, whole grains, extra virgin olive oil, red wine, a relatively low intake of unhealthy foods such as red meats, sweets and pasta, cheeses, butter, margarine, and food conventionally called fast food. Objective: This study aims at analyzing, in the elderly, the score of the MIND dietary pattern, and to investigate the association between this score and the presence of CMD. Methods: The sample for the present study is derived from the Health Survey - ISA Capital Nutrition, in the period of 2015. In this sample, 545 elderly (over 60 years) of both sexes were studied. The dietary data of the sample were obtained from two 24-hour dietary reminders that were corrected for intrapersonal variability to identify the usual diet and calculated for the intake of the dietary groups that constitute the MIND diet. In addition, adherence to the MIND diet was identified from the median ingestion of the previously determined groups. The presence of CMD was assessed by the application of SRQ-20. Some adjustment variables (gender, age, physical activity pattern, presence of chronic diseases, income and schooling) were also considered. Results: the participants were mostly female, inactive, with chronic diseases. There was no significant association with adherence to the MIND and CMD scores, however, some dietary components, when associated alone, showed a significant and protective association (green leafy vegetables, other no-leafy vegetables and legumes). In turn, the consumption of red meat showed a significant and harmful association. Conclusion: The present study did not find a significant association between the MIND and TMC diet scores among the elderly, however, when analyzing the components of the isolated MIND dietary pattern in relation to the TMC, a positive correlation was found for the leafy green vegetable groups, other vegetables and legumes and negative correlation for the red meat group. Thus, nutritional strategies focused on brain function health, with a focus on higher consumption of protective foods and lower consumption of non-protective foods present in the MIND diet, can benefit the population, especially the elderly.

Diferentes pessoas podem ter atitudes diferentes frente a um mesmo objeto, mas esta diversidade de posicionamento não deve ser encarada como características idiossincráticas ou estáveis, não nascem num vazio social, são fruto de interação social, de processo de comparação, identificação e diferenciação social que permite situar uma posição frente a outras em um determinado momento. A família, enquanto grupo, atravessa os tempos passando por inúmeras transformações e críticas, sem se afastar da responsabilidade e das exigências dos papéis socialmente atribuídos a ela. O transtorno mental permanece ainda obscuro, não existindo uma causa que o explique como tão estigmatizante, mas, o adoecer psíquico, é facilmente percebido, pois, os indivíduos que adoecem, apresentam comportamentos diferentes daqueles normalmente aceitos pela sociedade. Os grupos de autoajuda são homogêneos, seus participantes passam pelo mesmo sofrimento, são de apoio mútuo e educacional, a liderança vem do interior do grupo, reporta-se somente a um único evento desestruturador de vida, os membros participam voluntariamente, sem fins lucrativos, objetivam o crescimento pessoal dos integrantes e tem caráter anônimo e confidencial. Partindo-se do princípio de que as atitudes frente aos transtornos mentais e seus portadores são passíveis de serem trabalhadas e modificadas, mesmo sendo necessário um trabalho ao longo de um grande período de tempo, pois envolve aspectos formadores da personalidade, este estudo teve como objetivo mostrar as atitudes frente aos transtornos mentais de familiares de portadores de transtornos mentais que participam de grupo de autoajuda, de familiares que não participam de grupos desta natureza e estudar comparativamente as atitudes destes dois grupos. Para isso, 20 familiares de portadores de transtornos mentais, sendo 10 familiares que participam de um grupo de autoajuda e 10 familiares que nunca participaram de grupo de autoajuda, responderam a um questionário com uma parte sobre os seus dados pessoais e a outra parte com perguntas abertas sobre sua proximidade com o seu parente portador de transtorno mental e a escala de atitudes \"Opiniões Sobre os Transtornos Mentais\" (OTM). Os resultados mostraram que em ambos os grupos a faixa etária dos familiares está acima dos 50 anos, a maioria são mães, casadas, católicas, com tempo de convívio com o parente portador de transtorno mental acima de 5 anos, a esquizofrenia é o transtorno mais frequente, sendo melhor a situação econômica dos familiares participantes do grupo de autoajuda. Os resultados da OTM, analisados de forma estatística utilizando-se o teste de Mann-Whitney U mostraram uma influência positiva do grupo de autoajuda nas atitudes de familiares de portadores de transtornos mentais frente aos transtornos mentais e seus parentes portadores desses transtornos, mas essa influência mostrou-se relativa, pois, os dois grupos, revelaram ainda atitudes autoritárias, restritivas e discriminadoras, levando à conclusão de que o grupo de autoajuda é extremamente importante e uma expressiva ferramenta de apoio, mas para uma real mudança de atitudes nos aspectos considerados, são necessárias modalidades terapêuticas mais específicas e que utilizam intervenções mais focadas. / Different people may have different attitudes towards a same object, but this range of positions should not be seen as idiosyncratic or stable characteristics. They are not born in a social void, but are the fruit of social interaction, of a comparison, identification and social distinction process that permits situating one position towards others at a given time. As a group, the family evolves going through countless transformations and criticism, without distancing itself from the responsibility and requirements of the roles it is socially attributed. Mental disorder is still obscure, without a cause to explain the extent of its stigma, but psychic illness is easily perceived, as the people who get ill display behaviors different from what society normally accepts. Self-help groups are homogeneous. Their participants go through the same suffering. The groups provide mutual support and are educational. Leadership comes from within the group, which only refers to a single deconstructive event in life. Members participate voluntarily, without aiming for profit. The groups aim for their members\' personal growth and are anonymous and confidential. Departing from the principle that attitudes towards mental disorders and their patients can be addressed and modified, although demanding long-term work, as it involves personality-building aspects, this study aimed to show the attitudes towards mental disorders of family members of mental disorder patients who participate in a self-help group, of family members who do not participate in this kind of groups, and to comparatively study these two groups\' attitudes. Thus, 20 relatives of mental disorder patients, ten of whom participate in a self-help group and ten who had never participated in a self-help group, answered a questionnaire. One part referred to their personal data, while the other part contained open questions on their proximity with their relative suffering from a mental disorder, as well as the attitude scale \"Opinions on Mental Disorders\" (OMD). The results showed that, in both groups, the relatives\' age range is over 50 years, most are mothers, married, Catholic, have lived with the relative suffering from the mental disorder for more than five years, schizophrenia is the most frequent disorder and the relatives who participate in the self-help group display a better socio-economic situation. Statistical analysis of the OMD results, using Mann-Whitney\'s U-test, showed a positive influence of the self-help group on the attitudes of mental disorder patients\' relatives towards the mental disorders and their relatives suffering from these disorders. This influence revealed to be relative though, as the two groups also revealed authoritarian, restrictive and discriminatory attitudes, leading to the conclusion that the self-help group is extremely important and a meaningful support tool. To achieve an actual change in attitudes towards the aspects under analysis though, more specific therapeutic modes are needed, which use more focused interventions.

Refletindo sobre a proposta da reabilitação psicossocial, o contexto em que vivem portadores de transtornos mentais e em algumas estratégias e concepções que constituíram o pensamento psiquiátrico e suas práticas terapêuticas, o teatro espontâneo do cotidiano se apresenta como um instrumento da terapia ocupacional importante. A terapia ocupacional estabelece como problemática de partida a exclusão social, e tem como objetivo final a inclusão social. Ao propor o teatro espontâneo do cotidiano como uma das atividades possíveis na clínica da terapia ocupacional, utilizou-se de um importante canal de expressão, onde, através do jogo dramático, o sujeito vivencia situações e papéis de uma maneira descompromissada. Desta forma, o estudo teve por objetivos compreender, através da técnica teatro espontâneo do cotidiano, o significado de ser um portador de transtorno mental e oferecer um instrumento para re-significações, contribuindo para a sua reabilitação psicossocial. Para isso, cinco portadores de transtornos mentais, usuários de um Centro de Atenção Psicossocial, participaram de doze encontros onde se utilizou o referido instrumento. Trata-se de um estudo transversal, de caráter qualitativo. Foram utilizadas filmagens e entrevistas. Para a análise dos dados optou-se pela análise de conteúdo temática sob a ótica do interacionismo simbólico. Assim, a partir da questão norteadora \"O que significa para você ser um portador de transtorno mental?\" foram destacadas as seguintes categorias: o transtorno mental, suas definições e causas; o portador de transtorno mental e a relação com a normalidade e aceitação; o portador de transtorno mental e a relação com o medicamento; o portador de transtorno mental e as perdas cotidianas; a relação da sociedade com o transtorno mental; o transtorno mental enquanto possibilidades, renovações e superações e o portador de transtorno mental e suas expectativas de vida. Verificou-se que estes significados estão atrelados à trajetória de vida e às diversas relações que os sujeitos estabelecem. Alguns destes significados ainda estão associados a uma lógica excludente e de segregação na qual o sujeito revela suas percepções acerca de questões normativas e do sofrimento pelas diversas perdas em seu cotidiano. Entretanto, os sujeitos indicaram caminhos positivos, de possibilidades, de renovação, de superação e de expectativas para o futuro. O estudo também revelou que o teatro espontâneo do cotidiano se apresentou como um agente facilitador da interação e expressão, propiciando uma construção criativa em busca de soluções para problemáticas da vida cotidiana, constituindo-se, assim, em um instrumento de valor significativo, que permite resignificações e contribui na reabilitação psicossocial de portadores de transtorno mental. Para tanto, a investigação revelou-se importante para se pensar em estratégias de assistência ao portador de transtorno mental que o ajude a transpor o sofrimento e permita uma nova interação com este. / Reflecting about the proposal of psychosocial rehabilitation, the context where the person with a mental disorder live and in some strategies and conceptions that constituted the psychiatric thought and its therapeutic practices, the spontaneous theater dramatization of daily life is presented as an occupational therapy important tool. Occupational therapy establishes the social exclusion as the starting problematic, and has the social inclusion as the final goal. By proposing the spontaneous theater dramatization of daily life as one of the possible activities in the occupational therapy clinic, it was used an important expression way, where, through the dramatic game, the subject experiences situations and roles in a not committed way. This way the study had as objectives comprehend, through the spontaneous theater dramatization of daily life, the meaning of being a person with mental disorder and offer a tool in order to regain meaning, contribution to their psycho-social rehabilitation. In order to do that, five people with mental disorders, members of a psychosocial center, participated in twelve meetings where it was used the mentioned tool. It is transversal study, of qualification character. It was used videos and interviews. To analyze the data the thematic analysis of content was chosen under the view of symbolic interactionism. Thus, from the north question \"what does it mean to you to be a person with a mental disorder?\" the following categories were highlighted. The mental disorder, its definitions and causes; the person with the mental disorder and the relation with the medication; the person with the mental disorder and the daily life losses; the relationship of the society and the mental disorder; the mental disorders as possibilities, renovations and overcoming, and the person with the mental disorder and his/her life expectations. It was verified that these meanings are related to the life track and the several relationships the subjects establish. Some of these meanings are still associated to a excluding and segregating logic in which the subject reveal his/her perceptions around social rules and the suffering from the various losses in his/her daily life. However, the subjects indicated positives ways, of possibilities, of renovations, of overcoming and expectations for the future. The study has also revealed the spontaneous theater dramatization of daily life was presented as a facilitator agent of the interaction and expression, allowing a creative construction in search of the daily life problems, constituting, thus, a valuable tool, that allows regain of meaning and contribute to the psycho-social rehabilitation of people with mental disorders. Therefore, the investigation became important in order to think of assistance strategies to the person with mental disorder that helps him/her overcome the suffering and allows a new interaction with this suffering.

Esse estudo elegeu como objeto de investigação a reabilitação psicossocial das pessoas com transtorno mental no contexto da reforma psiquiátrica brasileira. Para aproximação dessa realidade, analisamos as representações dos familiares produzidas a partir da experiência cotidiana nos serviços substitutivos de saúde mental e no domicilio junto ao parente com transtorno mental, explicitando os conflitos e contradições existentes e suas implicações na prática de cuidado da saúde e reabilitação psicossocial. Os sujeitos foram os familiares cuidadores de pessoas com transtorno mental severo e persistente, partícipes do grupo terapêutico de família dos Centros de Reabilitação Psicossocial (CAPS), na cidade de São Paulo (SP) - Brasil. Os achados foram coletados mediante entrevista semi-estruturada, observação e diário de campo e submetidos à Análise do Discurso com esteio no materialismo histórico-dialético mediante a qual foram extraídas as categorias temáticas. Constatamos que as concepções dos familiares acerca do transtorno mental, ainda, fortemente associadas aos signos estigmatizantes, determinam o modo como as famílias organizam o seu cotidiano, influenciando as atividades as relações interpessoais no âmbito familiar e social, os sentimentos, atitudes com relação ao sujeito acometido pelo transtorno, expectativas e perspectivas futuras no que refere à melhoria na qualidade de vida e inclusão social do sujeito acometido pelo transtorno mental e sua família. A maior parte dessas concepções é carregada de adjetivações negativas e adquirem conotação positiva, apenas, quando está presente a possibilidade de ganho secundário e a cura do transtorno mental é representada pela expectativa de retorno a normalidade e adaptação social / The focus of this study is the psychosocial rehabilitation of persons with mental disorders in the context of the Brazilian psychiatric reform. In order to gain insight into this reality, the study sought to perceive the familys representations which were produced from their daily experiences, dealing with substitutive services in mental health, and from the family member with the mental disorder, in the home, making explicit the existing conflicts and contradictions along with their implications in the practical care of psychosocial rehabilitation and health. The subjects were the care givers, being relatives, of those with severe, persistent mental disorder, who participated in the family therapeutic group of the Centers of Psycho-social Rehabilitation (CPR), in the city of Sao Paulo, SP, Brazil. The findings were collected through semi-structured interviews and diary field observation. The findings underwent discourse analysis with support in historical-dialectic materialism through which the thematic categories were extracted. We found that the families conceptions concerning mental disorder, still strongly associated with stigmatic signs, determined the manner in which they organized their daily life. These conceptions influenced the activities, the interpersonal relationships in the social, family context. They influenced the feelings and attitudes regarding the subject who carries the illness, as well as future expectations and perspectives regarding the improvement of the quality of life and the social inclusion of the individual suffering from the mental disorder, as well as of the family. The majority of these conceptions are latent with negative adjectives and acquire positive connotations only when there is a possibility of some secondary gain and when the cure of the mental disorder is represented by the return to normality and social adaptation