Optimizing Early Psychosis Care through Family Psychoeducation: A Systematic Review and Meta-Analysis

Family psychoeducation is a key psychosocial strategy in early psychosis care, but its specific effects for relatives of people with first-episode psychosis (FEP) remain uncertain. We conducted a systematic review and meta-analysis, registered in PROSPERO (CRD42024585814) and following PRISMA, to evaluate clinical and caregiver outcomes. Randomized and nonrandomized trials comparing structured programs with treatment as usual or other interventions were searched in PubMed, Embase, Scopus, and the Cochrane Library to April 2024. Fifteen studies (n=2,271) met criteria. Pooled results showed benefits for patients: lower risk of psychiatric hospitalization (risk ratio 0.64; 95% CI 0.45-0.90) and shorter inpatient stays (standardized mean difference [SMD] -0.29; 95% CI -0.50 to -0.09). Symptoms also improved, with reductions in general psychopathology (SMD -0.45; 95% CI -0.80 to -0.09), positive symptoms (SMD -0.36; 95% CI -0.63 to -0.09), and negative symptoms (SMD -0.32; 95% CI -0.49 to -0.15). Effects on negative symptoms persisted at two-year follow-up. No significant effects emerged for functioning or caregiver burden. Overall, family psychoeducation is a low-cost, feasible intervention that improves clinical outcomes and reduces service utilization in FEP, supporting incorporation into early-intervention programs.