The Influence of Familial Loading on the Course of Schizophrenic Symptoms and the Success of Psychoeducational Therapy

Abstract

This prospective study examines the influence of familial loading on the course of schizophrenic illness and the extent to which this is modifiable by psychoeducational training as a form of psychotherapy. 182 schizophrenic patients enrolled in the study were allocated at random into four different treatment groups and one control group. 40% of the patients had mentally ill relatives, 20% with some form of schizophrenia. Patients attending the treatment group and those in the control group were examined before and immediately after psychoeducational training and at 2-year and 5-year follow-ups. Control group patients with mentally ill relatives displayed a significant increase in psychopathological symptoms and rehospitalization rate compared to those without. The psychoeducational training arrested or even improved the increase in psychopathological symptoms in patients with mentally ill relatives. Familial loading contributes substantially to a high rehospitalization rate and a poor outcome in schizophrenic patients. Psychoeducational interventions are an appropriate means of arresting this unfavorable development.

Association between family history of psychiatric disorders and long-term outcome in schizophrenia – The Northern Finland Birth Cohort 1966 study

“…According to earlier studies the family histories of any psychiatric disorder have been associated with more severe psychopathological symptoms (based on Global Assesment Scale and Brief Psychiatric Rating Scale), more frequent rehospitalisation and higher risk of relapse in schizophrenia (Feldmann et al, 2001;Ciudad et al, 2012), but there are also contradictory findings (Ciudad et al, 2012;Altamura et al, 2001). Therefore the results in the present study are not surprising.…”

“…The results on the association between family history of any psychiatric disorder and outcome in schizophrenia are varying. Family history of psychiatric disorders has been associated with more psychopathological symptoms at a two-year follow-up and more rehospitalizations in a five-year follow-up (Feldmann et al, 2001), higher risk of relapse, but, interestingly, slightly less severe scores of psychopathology and a better attitude towards pharmacotherapy in a one-year follow-up (Ciudad et al, 2012). On the other hand, the number of relapses in a seven-year follow-up period did not differ based on psychiatric diagnoses in relatives (Altamura et al, 2001).…”

Family history of psychosis negatively impacts age at onset, negative symptoms, and duration of untreated illness and psychosis in first-episode psychosis patients

“…Most of the previous studies in this area have utilized small and heterogeneous patient samples, and have shown inconsistent findings. With respect to positive symptoms, the majority of findings have provided little to no support for an impact of FH (Feldmann et al, 2001; Malaspina et al, 2004; Martin Reyes et al, 2004; Chen et al, 2005; Norman et al, 2007). There is more evidence for a moderate relationship between FH and negative symptoms; however, here again the findings have been somewhat mixed (Sautter et al, 1994; Norman and Malla, 2001; Tabarés-Seisdedos et al, 2003; Ritsner et al, 2005;Arajärvi et al, 2006; Norman et al, 2007).…”

The Significance of Family History in First-Episode Schizophrenia Spectrum Disorder

“…Patient in that study had an average length of illness between 15 and 20 years and the measure of Norman et al The Journal of Nervous and Mental Disease • Volume 195, Number 10, October 2007 treatment response did not provide a clear separation of positive and negative symptoms. Several other past studies that have examined treatment outcome as a function of family history do not focus on first-episode patients and/or do allow a separate assessment of positive and negative symptoms (e.g., Chanpattana and Chakrabhand, 2001;Feldman et al, 2001;Ganev 2000;Nimgaonkar et al, 1988;Silverman et al, 1987;Verdoux et al, 1996).…”