Psychoeducation and relapse prevention

This paper reviews the rationale underlying psychoeducational programs designed to prevent or delay relapse in persons with schizophrenia. Since most of these programs have been oriented toward patients and their close relatives, the studies reviewed have tested the effect of these programs when added to maintenance pharmacotherapy. The results of the first generation of studies carried out in the late 1970s and 1980s confirmed the positive effects of a family-based psychoeducational program on delaying the recurrence of a schizophrenic episode. More recent studies, termed the second generation, have built on these findings to test more specific hypotheses concerning the most efficient format for delivery of such programs (relatives-only groups, single family-unit therapy, multiple-family groups). No clear advantage has been found for any one format, suggesting that intensive family involvement in the community care of schizophrenic, and other psychotic patients as well, may be a critical ingredient in successful relapse prevention programs.