Family Intervention for schizophrenia can decrease household stress
Researchers say that family support can help patients with schizophrenia recover faster and reduce hospitalization, said a report.
Relapses in schizophrenia are more common in families that are more expressive, critical and hostile. Intervention procedures are currently in use to reduce the levels of expressed emotions in such families.
"People with schizophrenia from families that express high levels of criticism, hostility, or over involvement, have more frequent relapses than people with similar problems from families that tend to be less expressive of emotions," write Fiona Pharoah, from Oxford and Buckinghamshire Mental Health NHS Foundation Trust, United Kingdom, and colleagues. "Forms of psychosocial intervention, designed to reduce these levels of expressed emotions within families are now widely used."
The main aim of this study, published in the Cochrane Database of Systematic Reviews, was to use data from randomized controlled trials (RCTs) or quasi-randomized trials to compare the psychosocial interventions in a community setting with the standard care given to patients. The reviewers used bibliographies of new included studies and updated the searches from The Cochrane Schizophrenia Group's Register.
Although some small, negative studies went undetected, family intervention definitely reduced the relapse frequency. In addition a decline in hospital admission was also observed. Social impairment and expression of emotions decreased with intervention.
Family support enabled patients to adhere to their prescriptions. But unfortunately, the dropout rates and suicidal tendencies remained the same. Also some of the data has been poorly reported in this study and the authors stress the need for a larger and better designed approach.
The study was accompanied by inherent drawbacks and individual patient data was not available in the review.The latest review was based on 15 additional trials including a total of 1765 participants.
"We still need a better designed large study to settle arguments about this widely used therapy," said co-author John Rathbone, from the Health Economics and Decision Science Department at the University of Sheffield. "Some of the important data within the studies that were reviewed were poorly reported and patients might have reason to feel let down by the research community in these cases."