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Severe strain has been repeatedly reported in the families of psychogeriatric patients. Nevertheless, many families continue to provide a great deal of support, despite the undoubted burden involved. A retrospective study of short-term outcome in 60 psychogeriatric referrals demonstrated the importance of some aspects of the relationship between the patient and their key supporting relative. In the sample as a whole, and in functional patients, the extent to which a positive communication system existed was significant. In patients with dementia, poor outcome was related to the patient being less dependent and more dominant in their interaction with the relative. The implications of this study for intervention and future research are discussed.