Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T04:07:48.534Z Has data issue: false hasContentIssue false
  • English
  • Français

Family psychoeducational interventions for schizophrenia in routine settings: impact on patients' clinical status and social functioning and on relatives' burden and resources

Published online by Cambridge University Press:  18 May 2011

Lorenza Magliano ,
Andrea Fiorillo ,
Claudio Malangone ,
Corrado de Rosa ,
Grazia Favata ,
Annarita Sasso ,
Monica Prezioso ,
Laura Pezzenati ,
Floralba Gentile  and
Lucetta Casale
...Show all authors
Lorenza Magliano*
Affiliation:
Dipartimento di Psichiatria, Università di Napoli SUN, Napoli; Centro di Salute Mentale di
Andrea Fiorillo
Affiliation:
Dipartimento di Psichiatria, Università di Napoli SUN, Napoli; Centro di Salute Mentale di
Claudio Malangone
Affiliation:
Dipartimento di Psichiatria, Università di Napoli SUN, Napoli; Centro di Salute Mentale di
Corrado de Rosa
Affiliation:
Dipartimento di Psichiatria, Università di Napoli SUN, Napoli; Centro di Salute Mentale di
Grazia Favata
Affiliation:
Torino
Annarita Sasso
Affiliation:
Torino
Monica Prezioso
Affiliation:
Milano
Laura Pezzenati
Affiliation:
Milano
Floralba Gentile
Affiliation:
La Spezia
Lucetta Casale
Affiliation:
La Spezia
Emi Bondi
Affiliation:
Bormio
Giuseppina Robustelli Test
Affiliation:
Bormio
Michele Di Lella
Affiliation:
Tortona
Elisabetta Discussi
Affiliation:
Tortona
Francesco Degl'Innocenti
Affiliation:
Firenze
Rossella Bellini
Affiliation:
Firenze
Rita Di Nunzio
Affiliation:
Foggia
Lucia Matrella
Affiliation:
Foggia
Rosa Salmeri
Affiliation:
Catania
Rosario Cantone
Affiliation:
Catania
Luisa Gargiulo
Affiliation:
Sorrento
Aniello Esposito
Affiliation:
Sorrento
Vincenzo Delcuratolo
Affiliation:
Barletta
Maria Giannini
Affiliation:
Barletta
Luisa Maresca
Affiliation:
Angri
Giovanna Cavaliere
Affiliation:
Angri
Barbara Scandone
Affiliation:
Settimo Torinese
Matteo Folla
Affiliation:
Settimo Torinese
Mauro Raffaeli
Affiliation:
Roma
Paola Innocente
Affiliation:
Roma
Flavia Dagianti
Affiliation:
Roma
Stefania Lucania
Affiliation:
Vetralla
Angela Scorsino
Affiliation:
Vetralla
Francesco Bardicchia
Affiliation:
Castel del Piano
Gennaro Cerullo
Affiliation:
Castel del Piano
Riccardo Curreli
Affiliation:
Oristano
Silvana Miscali
Affiliation:
Oristano
Mario Scordato
Affiliation:
Pace del Mela (ME)
Graziella Campo
Affiliation:
Pace del Mela (ME)
Mario Maj
Affiliation:
Dipartimento di Psichiatria, Università di Napoli SUN, Napoli; Centro di Salute Mentale di
*
Address for correspondence: Prof. L. MagHano, Dipartimento di Psichiatria, Università di Napoli SUN. Largo Madonna delle Grazie. 80138 Napoli. Fax:+39-81-5666523 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Objective — This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' clinical status and disability and relatives' burden and perceived support. Methods — The study has been carried out in 17 mental health centres. In each of them, 2 professionals were trained in a psychoeducational intervention and applied it for six months with families of users with schizophrenia. At baseline and six months later, patients' clinical status and disability, and relatives' burden, social network and professional support were assessed by validated tools. Results — Of the seventy-one recruited families, 48 (68%) completed the intervention. At six months, a significant improvement was found in patients' clinical status and social functioning, as well as in relatives' burden and social and professional support. In particular, the percentage of patients with poor or very poor global social functioning dropped from 50% to 27% at six months. Forty percent of patients and 45% of relatives reported a significant improvement in their social contacts over the intervention period. Conclusions — The results of this study confirm the hypothesis that psychoeducational family interventions may have a significant effect on social outcome and family burden in schizophrenia when provided in routine conditions.

Declaration of Interest: none of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by grants received from the “M. Lugli” Foundation (grant n. 2/18/8) and from the National Institute of Health, Italy (grant no. 1AL/F3).

Keywords

family psychoeducational interventionsschizophreniadisabilityfamily burdensocial network.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 15 , Issue 3 , September 2006 , pp. 219 - 227
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Barrowclough, C., Tanier, N., Lewis, S., Sellwood, W., Mainwaring, J., Quinn, J. & Hamlin, C. (1999). Randomized controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia. British Journal of Psychiatry 174, 505–511.CrossRefGoogle ScholarPubMed
Berglund, N., Vahlne, J.O. & Edman, A. (2003). Family intervention in schizophrenia - impact on family burden and attitude. Social Psychiatry and Psychiatric Epidemiology 38, 116–121.CrossRefGoogle ScholarPubMed
Cardin, V.A., McGill, C.W. & Falloon, I.R.H. (1985). An economic analysis: costs, benefits, and effectiveness. In Family Management of Schizophrenia (ed. Falloon, I.R.H.), pp. 115–123. John Hopkins University Press: Baltimore.Google Scholar
Falloon, I.R.H. (1985). Family Management of Schizophrenia: a Controlled Study of Clinical, Social, Family and Economic Benefits. John Hopkins University Press: Baltimore.Google Scholar
Falloon, I.R.H. (2003). Family interventions for mental disorders: efficacy and effectiveness. World Psychiatry 2, 20–28.Google ScholarPubMed
Falloon, I.R.H., Magliano, L., & Morosini, P.L. (1992). Intervento Psicoeducativo Integrato in Psichiatria. Edizioni Centro Studi Erickson: Trento.Google Scholar
Hazel, N.A., McDonell, M.G. & Short, R.A. (2004). Impact of multiple-family groups for outpatients with schizophrenia on caregivers' distress and resources. Psychiatric Services 55, 35–41.CrossRefGoogle ScholarPubMed
Leff, J. (2000). Family work for schizophrenia: practical application. Acta Psychiatrica Scandinavica 102, Supplementum No. 407, 78–82.CrossRefGoogle Scholar
Liberman, D.B. & Liberman, R.P. (2003). Rehab rounds: involving families in rehabilitation through behavioral family management. Psychiatric Services 54, 633–635.CrossRefGoogle ScholarPubMed
Lukoff, D., Nuechterlein, K.H. & Ventura, J. (1986). Manual for the expanded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin 12, 594–601.Google Scholar
Magliano, L., Guarneri, M., Marasco, C., Veltro, F. & Morosini, P.L. (1993). Studio di riproducibilità di un'intervista semi-strutturata per l'accertamento della disabilità sociale e del carico familiare (ADC). Rivista di Riabilitazione Psichiatrica e Psicosociale 1, 49–52.Google Scholar
Magliano, L., Fadden, G., Madianos, M., Caldas de Almeida, J.M., Held, T., Guarneri, M., Marasco, C., Tosini, P. & Maj, M. (1998a). Burden on the families of patients with schizophrenia: results of the BIOMED I study. Social Psychiatry and Psychiatric Epidemiology 33, 405–412.CrossRefGoogle ScholarPubMed
Magliano, L., Fadden, G., Economou, M., Xavier, M., Held, T., Guarneri, M., Marasco, C., Tosini, P. & Maj, M. (1998b). Social and clinical factors influencing the choice of coping strategies in relatives of patients with schizophrenia: results of the BIOMED I study. Social Psychiatry and Psychiatric Epidemiology 33, 413–419.CrossRefGoogle ScholarPubMed
Magliano, L., Marasco, C., Fiorillo, A., Malangone, C., Guarneri, M., Maj, M. & Working Group of the Italian National Study on Families of Persons with Schizophrenia. (2002). The impact of professional and social support on the burden of families of patients with schizophrenia in Italy. Acta Psychiatrica Scandinavica 106, 1–9.CrossRefGoogle ScholarPubMed
Magliano, L., Fiorillo, A., Fadden, G., Gair, F., Economou, M., Kallert, T., Schellong, J., Xavier, M., Pereira, M.G., Torres Gonzales, F., Palma-Crespo, A. & Maj, M. (2005a). Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: results of a study funded by the European Commission. World Psychiatry 4, 45–49.Google ScholarPubMed
Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., Favata, G., Sasso, A.R., Prezioso, M., Pezzenati, L., Gentile, F., Casale, L., Bondi, E., Robustelli Test, G., Di Leila, M., Biscussi, E., Degl'innocenti, F., Bellini, R., Di Nunzio, R., Matrella, L., Salmeri, R., Cantone, R., Gargiulo, L., Esposito, A., Del curatolo, V., Giannini, M., Maresca, L., Cavaliere, G., Scandone, B., Folla, M., Raffaeli, M., Innocente, P., Dagianti, F., Lucania, S., Scorsino, A., Bardicchia, F., Cernilo, G., Curreli, R., Miscali, S., Scordato, M., Campo, G., Mameli, C., Sodde, C., D'Ambra, L., Malacarne, A., Maj, M., Gruppo di Lavoro (2005b). Aspetti positivi e difficoltà nella diffusione degli interventi psicoeducativi familiari nella pratica clinica: uno studio multicentrico in 23 CSM italiani. Epidemiologia e Psichiatria Sociale 14, 235–242.CrossRefGoogle Scholar
Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., Maj, M. & the Family Intervention Working Group (2006). Implementing psychoeducational interventions in Italy for patients with schizophrenia and their families. Psychiatric Services 57, 266–269.CrossRefGoogle ScholarPubMed
Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., Maj, M. & the Family Intervention Working Group (in press). A pragmatic, randomized, controlled trial of a psychoeducational family intervention for schizophrenia on patients' personal/social functioning and relatives' burden and perceived support. Psychiatric Services.Google Scholar
McFarlane, W.R., Dixon, L., Lukens, E. & Lucksted, A. (2003). Family psychoeducation and schizophrenia: a review of the literature. Journal of Marital and Family Therapy 29, 223–245.CrossRefGoogle ScholarPubMed
Montero, I., Asencio, A., Hernandez, I., Masanet, M.J., Lacruz, M., Bellver, F., Iborra, M. & Ruiz, I. (2001). Two strategies for family intervention in schizophrenia: a randomized trial in a Mediterranean environment. Schizophrenia Bulletin 27, 661–670.CrossRefGoogle Scholar
Morosini, P.L. & Casacchia, M. (1995). Brief Psychiatric Rating Scale (BPRS) - versione 4.0, manuale d'istruzioni. In Come Valutare l'Esito nei Dipartimenti di Salute Mentale (ed. Ruggeri, M. e Dall'Agnola, R.B.), pp. 131–141. Il Pensiero Scientifico Editore: Roma.Google Scholar
Morosini, P.L., Veltro, F., Cerreta, A., Gaio, R., Palomba, U. & Ventra, C. (1988). Disabilità sociale e carico familiare. Studio di riproducibilità di un nuovo strumento di valutazione. Rivista Sperimentale di Freniatria 3, 541–563.Google Scholar
Morosini, P.L., Roncone, R., Veltro, F., Palomba, U. & Casacchia, M. (1991). Routine assessment tool in psychiatry: a case of questionnaire of family attitudes and burden. Italian Journal of Psychiatry and Behavioural Sciences 1, 95–101.Google Scholar
Mueser, K.T., Sengupta, A., Schooler, N.R., Bellack, A.S., Xie, H., Glick, I.D. & Keith, S.J. (2001). Family treatment and medication dosage reduction in schizophrenia: effects on patient social functioning, family attitudes, and burden. Journal of Consulting and Clinical Psychology 69, 3–12.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence (2002). Clinical Guideline I: Schizophrenia. Core linterventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. NICE: London.Google Scholar
Pekkala, E. & Merinder, L. (2002). Psychoeducation for schizophrenia. Cochrane Database Systematic Review, Issue 2.CrossRefGoogle Scholar
Pharoah, F.M., Rathbone, J., Mari, J.J. & Streiner, D. (2003). Family intervention for schizophrenia. Cochrane Database Systematic Review, Issue 3.CrossRefGoogle Scholar
Stam, H. & Cuijpers, P. (2001). Effects of family interventions on burden of relatives of psychiatric patients in the Netherlands: a pilot study. Community Mental Health Journal 37, 179–187.CrossRefGoogle ScholarPubMed
World Health Organization (1988). Psychiatric Disability Assessment Schedule (DAS). World Health Organization: Geneva.Google Scholar
Zubin, J. & Spring, B. (1977). Vulnerability - a new view of schizophrenia. Journal of Abnormal Psychology 86, 103–126.CrossRefGoogle ScholarPubMed