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Family intervention for schizophrenia.

F M Pharoah¹, J J Mari, D Streiner

¹Hinchingbrook Health Care, Park House, Nursery Road, Huntington, Cambridgeshire, UK, PE18 6RJ.

The Cochrane Database of Systematic Reviews

|May 5, 2000

Summary

Family psychosocial interventions may reduce relapse rates in schizophrenia care. However, current evidence is inconclusive, necessitating further research for definitive conclusions.

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Area of Science:

Psychiatry
Mental Health
Clinical Psychology

Background:

High levels of expressed emotion (criticism, hostility, over-involvement) in families are linked to increased relapse rates in individuals with schizophrenia.
Psychosocial interventions aim to reduce expressed emotion within families, thereby decreasing stress and relapse rates.
These interventions are considered adjuncts to pharmacotherapy, not replacements.

Purpose of the Study:

To evaluate the effectiveness of community-based family psychosocial interventions for schizophrenia care.
To compare family interventions against standard care in managing schizophrenia and related conditions.

Main Methods:

Systematic review of randomized or quasi-randomized studies.
Searches conducted in major databases including Cochrane Library, Cochrane Schizophrenia Group's Register, EMBASE, and MEDLINE.
Inclusion criteria: studies comparing community-oriented family-based psychosocial intervention (over five sessions) with standard care for families of individuals with schizophrenia or schizoaffective disorder.

Main Results:

Family intervention may reduce the frequency of relapse (1-year odds ratio 0.57; number needed to treat 6.5).
Evidence for decreased hospitalisation and improved medication compliance is limited and equivocal.
Potential improvements in social impairment and reduced family expressed emotion were observed, but data are insufficient to confirm effects on suicide rates or dropout tendencies.

Conclusions:

The current evidence base does not provide sufficient confidence in the effects of family interventions for schizophrenia care.
Further data from completed trials are crucial for informing clinical practice.
Additional trials with generalizable participants, interventions, and outcomes are warranted.

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