Psychological Medicine

Original Articles

Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study

M. Giróna1 c1, A. Fernández-Yañeza2, S. Mañá-Alvarengaa3, A. Molina-Habasa4, A. Nolascoa5 and M. Gómez-Beneytoa6a7

a1 Department of Clinical Medicine, University Miguel Hernández, Alacant, Spain

a2 Florida-Babel Mental Health Centre, Alacant, Spain

a3 Petrer Mental Health Centre, Petrer, Spain

a4 Ciutat Jardí Mental Health Centre, Alacant, Spain

a5 Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias, Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública, e Historia de la Ciencia, Universidad de Alacant, Alacant, Spain

a6 The Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain

a7 Ciber en Salud Mental, Instituto de Salud Carlos III, Madrid, Spain

Abstract

Background Empirical evidence of the efficacy and effectiveness of psychosocial family intervention and of the specificity of its effects on the course of schizophrenia is limited. The aim was to study the efficacy and effectiveness of psychosocial family intervention with regard to clinical and social functioning and family burden after controlling for compliance and several prognostic factors.

Method A 2-year randomized controlled trial with blind assessments. Fifty patients with DSM-IV schizophrenia and persistent positive symptoms and/or previous clinical relapse were allocated to psychosocial family intervention, individual counselling and standard treatment versus individual counselling and standard treatment.

Results Family intervention was associated with fewer clinical relapses, hospitalizations and major incidents, and an improvement in positive and negative symptoms, social role performance, social relations, employment and family burden. The reduction in hospitalizations in the family intervention group was significantly greater than that observed in the group of patients who refused to participate but this was not the case for the control group. The effects of family intervention were independent of compliance and prognostic factors.

Conclusions Family intervention is effective in severe schizophrenia independently of compliance and prognostic factors.

(Received September 21 2007)

(Revised April 08 2009)

(Accepted May 04 2009)

(Online publication June 03 2009)

Correspondence

c1 Address for correspondence: Dr M. Girón, Departamento de Medicina Clinica, Universitat Miguel Hernández, Campus de Sant Joan, Carretera Alacant-València (N-332) Km 87, 03550 Sant Joan d'Alacant, Spain. (Email: giron@icali.es)

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