Article

Integrated treatment of first-episode psychosis: Effect of treatment on family burden: OPUS trial

Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
The British journal of psychiatry. Supplement 09/2005; 48(48):s85-90. DOI: 10.1192/bjp.187.48.s85
Source: PubMed

ABSTRACT

The families of patients with first-episode psychosis often play a major role in care and often experience lack of support.
To determine the effect of integrated treatment v. standard treatment on subjective burden of illness, expressed emotion (EE), knowledge of illness and satisfaction with treatment in key relatives of patients with a first episode of schizophrenia-spectrum disorder.
Patients with ICD-10 schizophrenia-spectrum disorders (first episode) were randomly assigned to integrated treatment or to standard treatment. Integrated treatment consisted of assertive community treatment, psychoeducational multi-family groups and social skills training. Key relatives were assessed with the Social Behaviour Assessment Schedule (SBAS, burden of illness), the 5-min speech sample (EE), and a multiple choice questionnaire at entry and after 1 year.
Relatives in integrated treatment felt less burdened and were significantly more satisfied with treatment than relatives in standard treatment. There were no significant effects of intervention groups on knowledge of illness and EE.
The integrated treatment reduced family burden of illness and improved satisfaction with treatment.

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Available from: Merete Nordentoft, May 22, 2015
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    • "Multi-element intervention studies in FEP were excluded as the current review aims at understanding the evidence of a single intervention (family intervention). To clarify, family interventions were given in many early intervention trials along with patient-oriented pharmacological and non-pharmacological interventions such as social skill training, cognitive–behavioral therapy (CBT) and crisis intervention (Bertelsen et al., 2008; Craig et al., 2004; Grawe, Falloon, Widen, & Skogvoll, 2006; Jeppesen et al., 2005; Kuipers, Holloway, Rabe-Hesketh, & Tennakoon, 2004; Petersen et al., 2005; Tempier, Balbuena, Garety, & Craig, 2012). Such study reports were not included because it was difficult to isolate the efficacy of any single intervention (family intervention) effectiveness. "
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    Full-text · Article · Nov 2015 · SAGE Open
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    • "However, it was noted that in the absence of other primary caregivers, they play an important role in caring for their affected sibling.11,12) In this context, it is important to note that many psychosocial intervention studies with caregivers of psychosis have shown that the number of siblings who participated in the interventions are less compared to the parent and spouse caregivers.13,14,15,16,17,18,19,20,21,22) "
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    • "There have been cultural differences in the approach to such group work, with a family therapy approach more prevalent in the United States and Europe and a psychoeducation approach more prevalent in China, Brazil, and various developing countries (Mueser, 2011). The most highly investigated approach to group work for carers with a family member experiencing serious mental illness has been the multifamily group approach (Dyck, Hendryx, Short, Voss, & McFarlane, 2002; Hazel et al., 2004), based on the McFarlane model (McFarlane et al., 1995), incorporating the presence of the person experiencing mental illness; an approach now being utilized with people experiencing FEP and their families (Fjell et al., 2007; Jeppesen et al., 2005; Mullen, Murray, & Happell, 2002). In many FEP services, however, there has been a decision to provide a separate space for carers to voice their experiences and seek information in their own right (McWilliams et al., 2010; Pickett-Schenk et al., 2000; Sin et al., 2007). "
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