Family interventions for schizophrenia in Italy: randomized controlled trial.
Giuseppe Carrà, Cristina Montomoli, Massimi Clerici, Carlo Lorenzo Cazzullo
Author Information
Giuseppe Carrà: Department of Mental Health Sciences, Royal Free and University College Medical School, 48 Riding House Street, London W1W 7EY, UK. g.carra@ucl.ac.uk
OBJECTIVE: To evaluate the effectiveness of multiple group family treatment for Schizophrenia. METHOD: Relatives were randomly provided with an informative programme (n = 50), or allocated to receive an additional support programme (n = 26). Patients did not attend the programme to overcome cultural and organizational implementation barriers. The 12 and 24 months clinical and family outcomes were assessed. RESULTS: Patients' compliance with standard care was greater at 12 months in the more intensive behavioural management group over a control group receiving treatment as usual (TAU) (n = 25). A reduction in levels of expressed emotion (EE), significantly more frequent in those receiving the additional support programme than just the informative, occurred after treatment completion. Other clinical and family outcomes did not differ. However, treatment benefits declined at 24 months, when baseline high EE was again predictive of patient's admission and relatives were more vulnerable to objective burden. Baseline illness severity variables predicted a number of medium and long-term poor clinical outcomes. CONCLUSIONS: Although family psychoeducation has been tested in a wide range of Anglo-Saxon settings, there remains need to assess outcomes more internationally. Effective family interventions for people with schizophrenia probably require continued administration of key-elements or ongoing informal support to deal with the vicissitudes of illnesses.
