Psychoeducation Improved Illness Perception and Expressed Emotion of Family Caregivers of Patients with Schizophrenia

Abstract

Social interventions such as psychoeducation, in conjunction with appropriate antipsychotic medications, positively impact schizophrenic patients’ recovery. The aim of this 12-week study was to compare standard Indonesian mental healthcare for schizophrenia with psychoeducation-enriched care for family members, investigating both family and patient parameters. Sixty-four family participants meeting pre-set criteria were recruited from various online Indonesian community forums, social media, seminars/gathering events, and inpatient visits. Each family member was the main care provider for one patient with a schizophrenia diagnosis. Family participants were randomly allocated to one of two groups (control or intervention); both groups received equal personal time and attention from staff but the control group lacked the specific psychoeducational aspect of the intervention. In comparison with the control group, pre- and post-evaluation revealed significant positive effects in the intervention group for illness perception (F(ave) = 124.85; d(ave) = 2.72) and expressed emotion (OR(ave) = 0.39) among family members. For the patients, there was a significant positive effect on medication adherence (F(1, 62) = 21.54; p < 0.001, d(intervention) = 1.31) if their family members were in the intervention group. Partial least-squares path modeling revealed that low expressed emotion in family members was positively correlated with high medication adherence (β = −0.718; p < 0.001) in patients. This study provides evidence for the patient and family benefits of family psychoeducation on schizophrenia in a diverse Indonesian population.

High Expressed Emotion and Warmth among Families of Patients with Schizophrenia in Greece

“…Previous studies confirm the EE decrease of family members after psychoeducation and family interventions. Little knowledge and insufficient information regarding the mental disorder are considered to lead family members to express negative emotions [ 42 , 43 ].…”

“…Our study has some limitations, such as the lack of a structured interview to verify the diagnosis of schizophrenia. Neuroimaging, genetics, a neuropsychology assessment, personality and intelligence evaluation, electroencephalography, a drug - urine test to exclude organic or toxic psychosis were not included in the present study, as it is the case in many other EE studies to date [ 3 , 14 , 43 , 54 ], in which the diagnosis of schizophrenia has already been given by the treating physician, before the relatives, who are in the focus of the research interest, are recruited into the study. Moreover, in the present study and in order to reduce the possibility of including the relatives of individuals who did not have schizophrenia, relatives either of patients who used substances or had a shorter than 6-month follow up from the outpatient department were excluded from the sample.…”

Including families in schizophrenia treatment: a systematic review

“…FP is also considered to increase the role and function of the family as a caregiver who supports the patient's recovery, thereby reducing the rate of recurrence and hospitalization [8]. However, FP is often poorly implemented due to various obstacles such as scheduling difficulties and lack of access to care from specialists [6], [33], [34] Burden's family caring for a family member with schizophrenia has demanded the development of guidelines for the care of schizophrenia. However, the development of a guideline implementation strategy was insufficient and was examined in only a few studies.…”

Psychological Experience of Smoking Addiction in Family and Friends of Schizophrenic Adults Who Smoke Daily: A Qualitative Study

“…Treatments are very important not only to improve the quality of life of these patients but also to help their family and friends who experience a condition of psychological discomfort due to cigarette abuse by a family member. A study by Budiono indicates that family psychoeducation on the nature of schizophrenia is effective in positively changing family reactions and indirectly increasing patients' adherence to prescribed treatment [14]. Family members help and support the patient and assist in ensuring drug adherence.…”