Effects of a mutual support group for families of Chinese people with schizophrenia: 18-month follow-up

The Chinese University of Hong Kong, Hong Kong, 00, Hong Kong
The British Journal of Psychiatry (Impact Factor: 7.34). 08/2006; 189:41-9. DOI: 10.1192/bjp.bp.105.008375
Source: PubMed

ABSTRACT Family intervention in schizophrenia can reduce patient relapse and improve medication adherence, but few studies on this have involved a Chinese population.
To examine the effects of a mutual support group for Chinese families of people with schizophrenia, compared with psychoeducation and standard care.
Randomised controlled trial in Hong Kong with 96 families of out-patients with schizophrenia, of whom 32 received mutual support, 33 psychoeducation and 31 standard care. The psychoeducation group included patients in all the sessions, the mutual support group did not. Intervention was provided over 6 months, and patient- and family-related psychosocial outcomes were compared over an 18-month follow-up.
Mutual support consistently produced greater improvement in patient and family functioning and caregiver burden over the intervention and follow-up periods, compared with the other two conditions. The number of readmissions did not decrease significantly, but their duration did.
Mutual support for families of Chinese people with schizophrenia can substantially benefit family and patient functioning and caregiver burden.

Download full-text


Available from: David R Thompson, Jun 22, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The introduction of second-generation antipsychotics and cognitive therapies for schizophrenia over the past two decades generated considerable optimism about possibilities for recovery. To what extent have these developments resulted in better outcomes for affected individuals? What is the current state of our science and how might we address the many unmet needs in the prevention and treatment of schizophrenia? We trace the evolution of various treatments for schizophrenia and summarize current knowledge about available pharmacological and psychosocial treatments. We consider the widely prevalent efficacy-effectiveness gap in the application of available treatments and note the significant variability in individual treatment response and outcome. We outline an individualized treatment approach which emphasizes careful monitoring and collaborative decision-making in the context of ongoing benefit-risk assessment. We note that the evolution of both pharmacological and psychosocial treatments thus far has been based principally on serendipity and intuition. In view of our improved understanding of the etiology and pathophysiology of schizophrenia, there is an opportunity to develop prevention strategies and treatments based on this enhanced knowledge. In this context, we discuss potential psychopathological treatment targets and enumerate current pharmacological and psychosocial development efforts directed at them. Considering the stages of schizophrenic illness, we review approaches to prevent progression from the pre-symptomatic high-risk to the prodrome to the initial psychotic phase to chronicity. In view of the heterogeneity of risk factors, we summarize approaches towards targeted prevention. We evaluate the potential contribution of pharmacogenomics and other biological markers in optimizing individual treatment and outcome in the future.
    Schizophrenia Research 09/2010; 122(1-3):1-23. DOI:10.1016/j.schres.2010.05.025 · 4.43 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Relatives of patients suffering from schizophrenia are a highly burdened group. While benefits of integrating them into routine care are internationally recognised only a fraction receive adequate interventions. The present study investigates the utilisation of an open group for relatives, variables potentially associated with it and relatives' reasons for and against its utilisation. 147 relatives of in-patients and patients attending a day hospital where assessed using the General Health Questionnaire (GHQ), the Family Problem Questionnaire (FPQ), the WHO Quality of Life-BREF (WHOQOLBREF) and a questionnaire inquiring about the utilisation of an open group for relatives. Overall, 60 relatives attended the group routinely offered at the hospital. Especially those with higher weekly contact time with patients, lower quality of life, higher subjective burden and a less positive attitude towards the patient were attenders. Important reasons to decline the offer were feelings of timidity, fear and shame, resignation and disavowal. Despite their high burden, relatives have reservations about professional support intended for them and they feel highly stigmatised. Successful integration of relatives into psychiatric care requires empathy and strong commitment.
    Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 02/2009; 23(1):26-34. · 1.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Non-adherence to antipsychotic medication is commonly found in schizophrenia and other psychotic disorders, thus forming a major obstacle to long-term maintenance treatment and contributing to high relapse rates. With limited evidence on the success of interventions in enhancing medication adherence, this controlled trial was designed to test and evaluate the effectiveness of an adherence therapy (AT) for outpatients with schizophrenia spectrum disorders, based on a motivational interviewing approach over a six-month follow-up period. A single-blind, randomized controlled trial with a repeated-measures, two parallel groups design was conducted in a random sample of 114 participants with schizophrenia spectrum disorders in one community psychiatric nursing service. After pre-test, the participants were randomly assigned to either an eight-session course of AT plus usual care or usual psychiatric care (n = 57 per group). The main outcomes, including medication adherence, symptom severity, insight into treatment, hospitalization rate, and functioning, were measured at baseline and immediately and six months post-intervention. A total of 110 participants completed this trial and thus the attrition rate was 3.5 %. Results of repeated-measures analysis of variance followed by Helmert's contrasts test indicated that the AT participants reported significantly greater improvements in their insight into illness and/or treatment, psychosocial functioning, symptom severity, number of re-hospitalizations, and medication adherence (F = 5.01 to 7.45, P = 0.007 to 0.030) over six months follow-up, when compared with usual care. Motivational interviewing-based AT for people with schizophrenia can be effective to reduce symptom severity and re-hospitalizations, and improve medication adherence, functioning, and insight into illness and/or treatment over a medium term (six months) period of follow-up. Further study on the effects of AT in people with psychotic disorders in terms of diverse sociodemographic and illness characteristics, and a longer term (for example, over 12 months) follow-up period is recommended. The trial was registered at (identifier: NCT01780116 ) on 6 July 2014.
    Trials 06/2015; 16(1):270. DOI:10.1186/s13063-015-0785-z · 2.12 Impact Factor