Family intervention for schizophrenia

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dc.contributor.authorPharoah, Fiona
dc.contributor.authorMari, Jair de Jesus [UNIFESP]
dc.contributor.authorRathbone, John
dc.contributor.authorWong, Winson
dc.contributor.institutionOxford & Buckinghamshire Mental Hlth NHS Fdn Trus
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Sheffield
dc.contributor.institutionYorkshire & Humber Postgrad Deanery
dc.date.accessioned2016-01-24T13:59:04Z
dc.date.available2016-01-24T13:59:04Z
dc.date.issued2010-01-01
dc.description.abstractBackgroundPeople 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. Forms of psychosocial intervention, designed to reduce these levels of expressed emotions within families, are now widely used.ObjectivesTo estimate the effects of family psychosocial interventions in community settings for people with schizophrenia or schizophrenia-like conditions compared with standard care.Search strategyWe updated previous searches by searching the Cochrane Schizophrenia Group Trials Register (September 2008).Selection criteriaWe selected randomised or quasi-randomised studies focusing primarily on families of people with schizophrenia or schizoaffective disorder that compared community-orientated family-based psychosocial intervention with standard care.Data collection and analysisWe independently extracted data and calculated fixed-effect relative risk (RR), the 95% confidence intervals (CI) for binary data, and, where appropriate, the number needed to treat (NNT) on an intention-to-treat basis. for continuous data, we calculated mean differences (MD).Main resultsThis 2009-10 update adds 21 additional studies, with a total of 53 randomised controlled trials included. Family intervention may decrease the frequency of relapse (n = 2981, 32 RCTs, RR 0.55 CI 0.5 to 0.6, NNT 7 CI 6 to 8), although some small but negative studies might not have been identified by the search. Family intervention may also reduce hospital admission (n = 481, 8 RCTs, RR 0.78 CI 0.6 to 1.0, NNT 8 CI 6 to 13) and encourage compliance with medication (n = 695, 10 RCTs, RR 0.60 CI 0.5 to 0.7, NNT 6 CI 5 to 9) but it does not obviously affect the tendency of individuals/families to leave care (n = 733, 10 RCTs, RR 0.74 CI 0.5 to 1.0). Family intervention also seems to improve general social impairment and the levels of expressed emotion within the family. We did not find data to suggest that family intervention either prevents or promotes suicide.Authors' conclusionsFamily intervention may reduce the number of relapse events and hospitalisations and would therefore be of interest to people with schizophrenia, clinicians and policy makers. However, the treatment effects of these trials may be overestimated due to the poor methodological quality. Further data from trials that describe the methods of randomisation, test the blindness of the study evaluators, and implement the CONSORT guidelines would enable greater confidence in these findings.en
dc.description.affiliationOxford & Buckinghamshire Mental Hlth NHS Fdn Trus, SW Community Mental Hlth Team, High Wycombe HP13 6EQ, Bucks, England
dc.description.affiliationUniversidade Federal de São Paulo, Dept Psiquiatria, BR-04023900 São Paulo, Brazil
dc.description.affiliationUniv Sheffield, HEDS, ScHARR, Sheffield, S Yorkshire, England
dc.description.affiliationYorkshire & Humber Postgrad Deanery, Sheffield, S Yorkshire, England
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Psiquiatria, BR-04023900 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipMcMaster University, Ontario, Canada
dc.description.sponsorshipUniversidade Federal de São Paulo, Brazil
dc.description.sponsorshipHinchingbrook Health Care, Cambridgeshire, UK
dc.description.sponsorshipInternational Clinical Epidemiology Network (INCLEN), USA
dc.format.extent156
dc.identifierhttp://dx.doi.org/10.1002/14651858.CD000088.pub3
dc.identifier.citationCochrane Database of Systematic Reviews. Hoboken: Wiley-Blackwell, n. 12, 156 p., 2010.
dc.identifier.doi10.1002/14651858.CD000088.pub3
dc.identifier.issn1469-493X
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32063
dc.identifier.wosWOS:000285159100003
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofCochrane Database of Systematic Reviews
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.subjectExpressed Emotionen
dc.subjectFamily Therapyen
dc.subjectSocial Supporten
dc.subjectFamily Relationsen
dc.subjectRandomized Controlled Trials as Topicen
dc.subjectRecurrence [prevention & control]en
dc.subjectSchizophrenia [therapy]en
dc.subjectHumansen
dc.titleFamily intervention for schizophreniaen
dc.typeinfo:eu-repo/semantics/article
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