Randomised-Control Trial of Family Intervention for 78 First-Episode Male Schizophrenic Patients

Abstract

At the time of discharge from their first stay in psychiatric hospital, 78 male schizophrenic patients were randomly assigned to a family intervention (experimental) group or a ‘standard care’ control group and were followed for the next 18 months. The family intervention consisted of both group and individual counselling sessions every 1–3 months that focused on education about the illness and on methods of dealing with the patient. There was a significantly lower rate of hospital readmission in the family intervention group than in the control group (15.4% versus 53.8%, χ2= 12.75, P<0.01), and the mean hospital-free period for those who were readmitted was significantly longer in the experimental group than in the control group (245 days versus 130 days, t =2.91, P<0.01). Moreover, the clinical status and overall level of functioning in patients who were not readmitted were significantly better in experimental subjects than in control subjects. Stratified analysis showed that family intervention and regular use of medication had independent and additive effects on the outcome. During the 18 months after the index discharge patients who did not take medication regularly and who did not receive family intervention were 7.9 times as likely to be readmitted to hospital as patients who took medication regularly and received family intervention.

The role of psycho-education in improving outcome at a general hospital psychiatry clinic in Uganda

“…This is often an aim in the mutual support group model. 12,13 Nor was this desirable. The goal was to offer a more general model of psychoeducation applicable to multiple diagnoses.…”

Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy

“…From six studies, information was available on readmission rates for up to 2 years into treatment (Falloon et al 1982 ;Glynn et al 1992 ;Xiong et al 1994 ;Zhang et al 1994 ;Buchkremer et al 1995 ;Schooler et al 1997). Family interventions showed consistent benefits over all other treatments in the number of patients readmitted to hospital, even over this prolonged period.…”

“…Sixteen trials provided data on treatment non-compliance in family interventions compared to all other treatments, including standard care (Goldstein et al 1978 ;Falloon et al 1982 ;Leff et al 1982Leff et al , 1989Hogarty et al 1986Tarrier et al 1988 ;Glynn et al 1992 ;Posner et al 1992 ;Vaughan et al 1992 ;Zhang et al 1994 ;Bloch et al 1995 ;Buchkremer et al 1995 ;Schooler et al 1997).…”

The economic impact of psychotherapy: a review

“…The Zhang et al study (29) demonstrated that family intervention and regular use of medication had independent and additive beneficial effects. The data of Spiegel and Wissler (24) showed that while family consultation in the home for recently discharged schizophrenic patients did not prevent readmission, it did provide a significant decrease in time spent in the hospital for the first 3 months.…”