Special Section: A Memorial Tribute: Patient Functioning and Family Burden in a Controlled, Real-World Trial of Family Psychoeducation for Schizophrenia

Department of Psychiatry, Second University of Naples SUN, Largo Madonna delle Grazie, Naples I-80138, Italy. lorenza.
Psychiatric Services (Impact Factor: 2.41). 01/2007; 57(12):1784-91. DOI: 10.1176/
Source: PubMed

ABSTRACT This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' personal and social functioning as well as on relatives' burden and perceived support.
Thirty-four mental health professionals from 17 public mental health centers in Italy selected 71 families of consumers with schizophrenia. Forty-two families were randomly assigned to a group that received the intervention for six months, and 29 families were assigned to a waiting list for six months. At baseline and six months later, validated tools were used to assess patients' clinical status, personal and social functioning, and social network as well as relatives' burden, social resources, and perception of professional support.
In the intervention group the number of patients with poor or very poor global personal and social functioning decreased significantly, from 17 (47 percent) at baseline to nine (25 percent) at follow-up. A significant improvement was found for the intervention group in patients' social relationships, interests in obtaining a job, maintenance of social interests, and management of social conflicts. Twenty-seven patients (74 percent) reported that their social relationships had improved during the six-month period. For both the intervention and control groups, family burden significantly improved. Relatives' social contacts and perception of professional support significantly increased only in the intervention group.
The results suggest that a psychoeducational family intervention may have a significant impact on functional outcomes of schizophrenia when provided to patients and caregivers in real-world settings.

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Available from: Lorenza Magliano, Sep 29, 2015
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    • "Family Psychoeducational Interventions Table 1 shows the main characteristics of family psychoeducational interventions for schizophrenia involving families in Italy, the results of which have been published in the international literature (Aguglia et al., 2007; Bazzoni et al., 2003; Carrà et al., 2007; Magliano et al., 2006; Roncone et al., 2002; Veltro et al., 2006). Informationeducational interventions mainly based on sharing information about the disease and its management were inspired by the model of Leff et al. (1989) or the Munich Psychosis Information Project Study by the German group of Pitschel-Walz et al. (2006) and Bauml et al. (2007). "
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    ABSTRACT: In Italy, as in many countries, relatives are closely involved in caring for persons with physical and mental disorders. The Italian scenario lends itself to routine involvement of family members in psychiatric treatment because, despite becoming smaller and smaller, Italian families keep close ties, and men and women do not leave the parental home until relatively late. The authors describe the impact of international family psychosocial research on the Italian mental health services (MHSs) and the main psychosocial interventions currently in use, including family psychoeducational interventions and the "Milan family therapy approach." They also highlight the contribution Italian researchers have given to the study of important variables in integrated mental disorder care, such as family burden of care, relatives' attitudes, family functioning, and satisfaction with the MHSs. Finally, they discuss the difficulties of implementing and disseminating family interventions within the Italian MHS, despite the growing evidence of their effectiveness.
    Journal of Nervous & Mental Disease 06/2014; 202(6):487-497. DOI:10.1097/NMD.0000000000000149 · 1.69 Impact Factor
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    • "Psychoeducation might be an important factor in reducing setbacks after discharge.11 Family education proved to be useful in improving the social functioning of individuals with schizophrenia,42 while family and patient psychoeducation effectively reduced relapse rates in individuals with the disorder.43 Regarding individuals with bipolar disorder, psychoeducation had a positive impact in hospitalization rates, number of mood episodes, and time between episodes.44 "
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    ABSTRACT: Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue.
    Psychology Research and Behavior Management 04/2014; 7:137-145. DOI:10.2147/PRBM.S35061
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    • "Family interventions described in previous randomized controlled trials (RCTs) [6-8] are psycho-educational in nature and seek to improve patients and primary caregivers’ knowledge of schizophrenia and change patients and primary caregivers’ behaviour by improving their knowledge about expected ‘maladaptive’ behaviour, disease symptoms and how can they deal with these issues using psycho-educational interventions [9]. Whilst the content psycho-educational intervention varies between studies, there are common factors among most studies [7,10-12] including; general information about schizophrenia, symptoms, medication management, problem-solving strategies and communication skills for patients and primary caregivers. Psycho-educational interventions are usually delivered by psychiatrists [13]. "
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    ABSTRACT: Schizophrenia is one of the most serious forms of mental illness among people being treated in psychiatric clinics in developing and developed countries. Providing care for people diagnosed with schizophrenia can be stressful for their caregivers. Psycho-educational interventions may improve patients' and primary caregivers' knowledge of schizophrenia and impact positively on patients' physical and psychological outcomes and primary caregivers' burden of care and quality of life. Studies thus far have shown that these interventions may improve patients' and caregivers' outcomes, but the quality of included randomized controlled trials (RCTs) is poor and it is difficult to draw firm conclusions as to the effectiveness of such interventions on patients and primary caregivers' outcomes, hence the current study. A randomized controlled trial in four outpatient mental health clinics in Jordan comparing psycho-educational interventions in the form of six booklets every fortnight, with treatment as usual in people diagnosed with schizophrenia and their primary caregivers. The primary outcome for participants is knowledge of Schizophrenia; secondary outcomes for patients are positive and negative symptoms of schizophrenia and relapse rate, while secondary outcomes for primary caregivers are burden of care and quality of life. All measures are assessed at baseline, immediately post-intervention and at three months follow-up. This randomized control trial, conducted in Jordan among people living with schizophrenia and their primary caregivers, will assess the effect of psycho-educational interventions on knowledge of Schizophrenia, patients' positive and negative symptoms and quality of life, and caregivers' burden of care.Trial registration: Current Controlled Trials ISRCTN78084871.
    BMC Psychiatry 01/2014; 14(1):17. DOI:10.1186/1471-244X-14-17 · 2.21 Impact Factor
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