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Chow JYA, Yeo YTT, Goh YS. Effects of Psychoeducation on Caregivers of Individuals Experiencing Schizophrenia: A Systematic Review and Meta-Analysis. Int J Ment Health Nurs 2024. [PMID: 39252184 DOI: 10.1111/inm.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/13/2024] [Accepted: 08/23/2024] [Indexed: 09/11/2024]
Abstract
The existing paradigm on recovery in mental health prioritises self-empowerment and person-centred, community-based care, which necessitates family caregivers' collaboration to support individuals with schizophrenia in the community. However, the role of family caregivers is often under-recognised and hence insufficiently supported. This consequently compromises caregivers' well-being and, ultimately, the recovery of individuals with schizophrenia. Although caregiver-targeted psychoeducation may offer practical support, its effectiveness lacks conclusive evidence. This review aimed to evaluate the impacts of psychoeducation on caregiver-related outcomes (caregiver burden, quality of life and expressed emotion). Eight electronic databases were searched from inception to September 2023, supplemented by hand searching of end-reference lists. Two reviewers independently conducted title and abstract screening with predetermined eligibility criteria. A third reviewer was consulted to resolve any discrepancies. A random-effects meta-analysis was performed to estimate pooled effect sizes alongside subgroup and sensitivity analyses where appropriate. Twenty-one studies (totalling 1639 caregivers) were included, based on which psychoeducation contributed to a statistically significant improvement in caregiver-related outcomes. Given substantial heterogeneity, subgroup and sensitivity analyses were done for the durations and the evaluative scales for psychoeducation. Quality appraisal revealed unclear or high bias in most studies. Notwithstanding the heterogeneity, the directions of the effect sizes consistently indicated the effectiveness of psychoeducation across all outcomes. This finding aligned with Lazarus' stress appraisal and coping theory, which states that psychoeducation improves caregivers' knowledge, coping mechanisms and situation appraisal. Our findings offer encouraging evidence to advocate the integration of psychoeducation into healthcare services, but policy-based support is warranted for sustained implementation. Further research is merited to optimise its duration and content and appraise its long-term impacts through disease-specific scales for objective and subjective outcomes.
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Affiliation(s)
- Jin Yin Alicia Chow
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yu Ting Tracy Yeo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Sampogna G, Brohan E, Luciano M, Chowdhary N, Fiorillo A. Psychosocial interventions for carers of people with severe mental and substance use disorders: a systematic review and meta-analysis. Eur Psychiatry 2023; 66:e98. [PMID: 37997647 PMCID: PMC10755580 DOI: 10.1192/j.eurpsy.2023.2472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Severe mental disorders - such as schizophrenia, bipolar disorder, and substance use disorders - exert a negative impact not only on affected people but also on their carers. To support carers of people with severe mental disorders, several psychosocial interventions have been developed. METHODS This systematic review and meta-analysis aimed to assess whether psychosocial interventions for carers of persons with schizophrenia, bipolar disorder, or substance use disorders produce benefit/harm with respect to a series of outcomes - including subjective and objective burden, depressive symptoms, well-being/quality of life, sleep, skills/knowledge, self-efficacy, physical health - as compared to standard support/support as usual or other control conditions. RESULTS In carers of persons with schizophrenia, psychoeducational interventions were associated with significant improvement in personal burden, well-being, and knowledge about the illness; and a supportive-educational intervention with an improvement in personal burden. In carers of persons with bipolar disorder, psychoeducational interventions were associated with significant improvement in personal burden and depressive symptoms; family-led supportive interventions with an improvement in family burden; family-focused intervention and online "mi.spot" intervention with a significant reduction in depressive symptoms. Psychosocial interventions used for carers of persons with substance use disorders were found to be overall effective on the level of well-being, but the low number of trials did not allow detection of differences between the various psychosocial interventions. CONCLUSIONS The quality of the evidence ranged from very low to moderate, suggesting the need for further better-quality research.
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Affiliation(s)
- Gaia Sampogna
- Department of Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy
- WHO Collaborating Centre for Research and Training, Naples, Italy
| | - Elaine Brohan
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Mario Luciano
- Department of Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy
- WHO Collaborating Centre for Research and Training, Naples, Italy
| | - Neerja Chowdhary
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Andrea Fiorillo
- Department of Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy
- WHO Collaborating Centre for Research and Training, Naples, Italy
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Okafor AJ, Monahan M. Effectiveness of Psychoeducation on Burden among Family Caregivers of Adults with Schizophrenia: A Systematic Review and Meta-Analysis. Nurs Res Pract 2023; 2023:2167096. [PMID: 37767330 PMCID: PMC10522442 DOI: 10.1155/2023/2167096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 07/05/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Caring for relatives living with schizophrenia could lead to caregivers' burden. It is believed that lack of information and understanding about schizophrenia and lack of skills to cope effectively while caring for their adult relatives largely contribute to the burden they experience. The burden is assessed using assessment scales. This review aims to assess the effectiveness of psychoeducation in alleviating the burden experienced by family caregivers of adults living with schizophrenia and to identify essential factors that facilitate positive outcomes. Five databases (ASSIA, CINAHL, Embase, MEDLINE EBSCO, and PsycINFO) were systematically searched using combinations of the following key terms: "family caregivers," "schizophrenia," "burden," "psychoeducation," and "adults." Meta-analysis of included studies was conducted using RevMan 5.4. Five RCTs with 320 family caregivers were included in the review. Overall, none of the studies showed a low risk of bias. The evidence suggests that face-to-face group psychoeducation reduced family caregivers' burden when measured across different time points: one-week postintervention (mean difference -3.87 and Cl -6.06 to -1.70), six months (MD -8.76 and Cl -12.38 to -5.13), and twelve months (MD -7.38 and Cl -9.85 to -4.91). Measurements immediately after the intervention, one month, and three months postintervention when reported narratively also showed a reduction in family caregivers' burden. Face-to-face group psychoeducation provided for family caregivers effectively alleviates the burden they experience. Factors such as program content and teaching methods facilitated positive outcomes. It is recommended that psychoeducation should be integrated as a routine intervention for family caregivers.
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Affiliation(s)
- Akunna Jane Okafor
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Mark Monahan
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Katsuki F, Watanabe N, Yamada A, Hasegawa T. Effectiveness of family psychoeducation for major depressive disorder: systematic review and meta-analysis. BJPsych Open 2022; 8:e148. [PMID: 35915980 PMCID: PMC9380172 DOI: 10.1192/bjo.2022.543] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Although its effect has not been verified, family therapy - such as family psychoeducation (FPE) - is a widely used intervention for treating major depressive disorder (MDD). To our knowledge, no systematic review and meta-analysis exists that examines the effect of FPE on MDD. AIMS To assess evidence on the effectiveness of FPE on depressive symptoms in people with MDD. METHOD We searched several databases - including PubMed, MEDLINE and Web of Science, among others - to identify eligible studies on the topic published up to March 2022. Our criteria included studies on participants with a primary MDD diagnosis and their family members and excluded studies on people with bipolar disorders and other mental illnesses. In the included studies, family members in the control groups did not receive FPE. Participants in both the intervention and control groups received standard treatment. Two researchers independently selected relevant publications, extracted data and evaluated methodological quality using the Cochrane risk of bias assessment tool and GRADE evaluation. The protocol was registered with PROSPERO (no. CRD42020185884). RESULTS The meta-analysis included five studies with 301 patients with MDD and their family members. The effect of FPE on patients' symptom severity, compared with the control condition, at 16 weeks was available for five comparisons of four randomised control trials (RCTs); a final follow-up was available for six comparisons of five RCTs. The meta-analysis showed a statistically significant improvement in patients' symptoms, compared with control, at 16 weeks (s.m.d. = -0.52, 95% CI -1.03 to -0.01) and at a final follow-up (s.m.d. = -0.53, 95% CI -0.98 to -0.08). The meta-analysis on the effect of FPE on family functioning showed a non-significant improvement both at 16 weeks and at final follow-up. CONCLUSIONS FPE had a small but statistically significant effect on depressive symptoms in people with MDD, in both the short and long term. However, according to the GRADE framework, all outcomes are graded very low on certainty; therefore, more high-quality research is needed.
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Affiliation(s)
- Fujika Katsuki
- Department of Psychiatric and Mental Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Norio Watanabe
- Department of Psychiatry, Soseikai General Hospital, Kyoto, Japan
| | - Atsurou Yamada
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takaaki Hasegawa
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
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Delibaş DH, Erdoğan E. Effects of a psychoeducation program on disease burden, depression, and anxiety levels in relatives of psychotic patients in a community mental health center. Perspect Psychiatr Care 2022; 58:940-945. [PMID: 34080706 DOI: 10.1111/ppc.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study evaluates the effect of a 10-week psychoeducation program (PP) on disease burden, depression, and anxiety levels in relatives of psychotic patients. DESIGN AND METHODS The participants were 43 relatives of patients attending a community mental health center. The Zarit Caregiver Burden Scale (ZCBS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were used to collect psychometric data. FINDINGS Administering the PP to caregivers significantly reduced their ZCBS, BAI, and BDI scores. PRACTICE IMPLICATIONS We recommend integrating the PP into treatment and rehabilitation programs within the scope of psychiatric-care services.
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Affiliation(s)
- Dursun H Delibaş
- Department of Psychiatry, Izmir Bozyaka Education and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Esin Erdoğan
- Department of Psychiatry, Izmir Bozyaka Education and Research Hospital, University of Health Sciences, Izmir, Turkey
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Determining the Family Sense of Coherence and Caregiving Burden of Caregivers of Patients with Schizophrenia: A-Cross Sectional Study*. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.993946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Psychoeducational groups for close relatives of patients with borderline personality disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01395-8. [PMID: 35294615 DOI: 10.1007/s00406-022-01395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
Psychoeducational groups for family members of patients with schizophrenia have proven to be effective. Borderline personality disorder (BPD) implies serious impairment in interpersonal relationships. Close relatives of individuals with BPD also show high levels of burden and need support. Psychoeducational groups could help to cope with the interactional problems in a relationship with a person with BPD. A manualised psychoeducational programme of 10 group sessions for close relatives of patients with BPD was tested. Measures administered at pretest and after 10 sessions were: perceived burden (IEQ-EU), knowledge about the disorder (WFBBPS-A) and quality of life (WHOQOL-BREF). For formative evaluation, a "Group Therapy Session Questionnaire" (participant and therapist version; GTS-A, GTS-T) was used. A total of 33 persons in three groups took part. Pre-post evaluations revealed a significantly lower level of burden and a significantly better knowledge about the disorder after participating in the psychoeducational group. Reduction of burden correlated significantly with the assessment of patients' symptom severity and carers' level of burden at study entry. There was no change in the quality of life. The participants and therapists generally rated the psychoeducational sessions very positively. The highest ratings were found in the sessions about communication skills and coping with crises. Findings indicate that the psychoeducational programme is well accepted and supportive for persons with close relationships to patients with BPD.
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ÖZCAN TOZOĞLU E, ALKAN E, ÖZPOLAT G. Covid-19 pandemisinde toplum ruh sağlığı merkezlerinin hizmet şekli değişikliği ile şizofreni hastalarındaki anksiyete düzeyleri arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.903054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sharma M, Srivastava S, Pathak A. Family Psychoeducation as an Intervention Tool in the Management of Schizophrenia and the Psychological Wellbeing of Caregivers. Indian J Community Med 2021; 46:304-308. [PMID: 34321748 PMCID: PMC8281868 DOI: 10.4103/ijcm.ijcm_683_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Caregivers need to be imparted with specialized skills to retain their psychological well-being and to manage the patient with schizophrenia effectively. Aim: This study aims to understand the role of family psychoeducation (FPE) in the management of schizophrenia and the well-being of caregiver. Materials and Methods: The sample included 40 caregivers and patients, 20 each assigned randomly in treatment group (psychoeducation given) and the control group. Pre and post assessment of psychological wellbeing (PWB), symptoms of the patient, and emotional regulation was done through the scales mentioned in the study and analyzed through analysis of variance. Results: Statistically significant improvement in emotional regulation of caregivers and patient (P = 0.05) and improvement of PWB in caregivers (P = 0.01) as well as significant reduction in symptoms of patients (P = 0.01) found in the treatment group. Conclusion: FPE was found to be effective in improving PWB of caregivers and effective management of a patient with schizophrenia.
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Affiliation(s)
- Meenu Sharma
- Department of Applied Psychology, School of Liberal Education, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Shikha Srivastava
- School of Liberal Education, Galgotias University, Greater Noida, Uttar Prades, India
| | - Abhijit Pathak
- Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, Odisha, India
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Yu Y, Li T, Xi S, Li Y, Xiao X, Yang M, Ge X, Xiao S, Tebes J. Assessing a WeChat-Based Integrative Family Intervention (WIFI) for Schizophrenia: Protocol for a Stepped-Wedge Cluster Randomized Trial. JMIR Res Protoc 2020; 9:e18538. [PMID: 32687478 PMCID: PMC7479588 DOI: 10.2196/18538] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Schizophrenia is a persistent and debilitating mental illness, and its prognosis depends largely on supportive care and systematic treatment. In developing countries like China, families constitute the major caregiving force for schizophrenia and are faced with many challenges, such as lack of knowledge, skills, and resources. The approach to support family caregiving in an accessible, affordable, feasible, and cost-effective way remains unclear. The wide-spread use of WeChat provides a promising and cost-effective medium for support. OBJECTIVE We aim to present a protocol for assessing a WeChat-based integrative family intervention (WIFI) to support family caregiving for schizophrenia. METHODS We will develop a WIFI program that includes the following three core components: (1) psychoeducation (WeChat official account), (2) peer support (WeChat chat group), and (3) professional support (WeChat video chat). A rigorous stepped-wedge cluster randomized trial will be used to evaluate the implementation, effectiveness, and cost of the WIFI program. The WIFI program will be implemented in 12 communities affiliated with Changsha Psychiatric Hospital through the free medicine delivery process in the 686 Program. The 12 communities will be randomized to one of four fixed sequences every 2 months during an 8-month intervention period in four clusters of three communities each. Outcomes will be assessed for both family caregivers and people with schizophrenia. Family caregivers will be assessed for their knowledge and skills about caregiving, social support, coping, perceived stigma, caregiver burden, family functioning, positive feelings, and psychological distress. People with schizophrenia will be assessed for their symptoms, functioning, quality of life, recovery, and rehospitalization. Cost data, such as intervention costs, health care utilization costs, and costs associated with lost productivity, will be collected. Moreover, we will collect process data, including fidelity and quality of program implementation, as well as user attitude data. Treatment effects will be estimated using generalized linear maximum likelihood mixed modeling with clusters as a random effect and time as a fixed effect. Cost-effectiveness analysis will be performed from the societal perspective using incremental cost-effectiveness ratios. Qualitative analysis will use the grounded theory approach and immersion-crystallization process. RESULTS The study was funded in August 2018 and approved by the institutional review board on January 15, 2019. Preliminary baseline data collection was conducted in May 2019 and completed in September 2019. The WIFI program is expected to start in September 2020. CONCLUSIONS This is the first study to assess a WeChat-based mHealth intervention to support family caregiving for schizophrenia in China. The innovative study will contribute to the development of a more cost-effective and evidence-based family management model in the community for people with schizophrenia, and the approach could potentially be integrated into national policy and adapted for use in other populations. TRIAL REGISTRATION ClinicalTrials.gov NCT04393896; https://clinicaltrials.gov/ct2/show/NCT04393896. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/18538.
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Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Tongxin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shijun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xi Xiao
- Department of Psychiatry, Changsha Psychiatric Hospital, Changsha, China
| | - Min Yang
- Department of Psychiatry, Changsha Psychiatric Hospital, Changsha, China
| | - Xiaoping Ge
- Department of Psychiatry, Changsha Psychiatric Hospital, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jacob Tebes
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
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Verma PK, Walia TS, Chaudhury S, Srivastava S. Family psychoeducation with caregivers of schizophrenia patients: Impact on perceived quality of life. Ind Psychiatry J 2019; 28:19-23. [PMID: 31879442 PMCID: PMC6929223 DOI: 10.4103/ipj.ipj_2_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/05/2019] [Accepted: 07/11/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Schizophrenia is a devastating and chronic mental illness. Considering the nature of illness along with routine psychiatric care, various supportive therapies are recommended. Family psychoeducational approach has been developed to increase patients' as well as their caregivers' knowledge and insight into their illness. It is postulated that this increased knowledge and insight will enable people with schizophrenia and their caregivers to cope in a more effective way with the consequences of their illness, thereby improving prognosis. AIM The aim of this study is to assess the efficacy of family psychoeducation intervention on the caregivers of schizophrenia patients with respect to their perceived quality of life. MATERIALS AND METHODS A total of 30 caregivers of male schizophrenia patients were selected through purposive sampling technique. Patients were divided into two groups, namely, experimental and control group. Family psychoeducation intervention was given on twice-monthly basis for 6 months to the experimental group caregivers. Baseline assessment was carried out with the help of WHO Quality of Life-BREF followed by intervention and then posttherapeutic assessment was done with same tool. RESULTS Most of the caregivers were above 40 years of age group, married, and male. Following family psychoeducation, significant improvement in overall quality of life scores was observed in experimental group caregivers compared to control group caregivers where no such intervention was provided. CONCLUSION Family psychoeducation is feasible and useful in our clinical population.
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Affiliation(s)
- Pankaj Kumar Verma
- Department of Psychiatric Social Work, Ranchi Institute of Neuropsychiatry and Allied Sciences, Ranchi, Jharkhand, India
| | | | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pimpri, Maharashtra, India
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Attepe Özden S, Tuncay T. The experiences of Turkish families caring for individuals with Schizophrenia: A qualitative inquiry. Int J Soc Psychiatry 2018; 64:497-505. [PMID: 29862853 DOI: 10.1177/0020764018779090] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Turkey, individuals with schizophrenia usually live with their families. Therefore, families are main caregivers and face psychological, financial and social problems. AIM The aim of this study is to understand the personal burdens and coping strategies, and social support affecting the families that provide care to the individuals with schizophrenia. METHODS In-depth interviews were conducted with 31 members of 12 families. RESULTS Four themes were formed: learning and accepting the disorder, caregiving, social dimensions and service dimensions. Families have a problem with accepting this order and caregiving affects their quality of life both financially and socially. As schizophrenia is one of the reasons for being isolated from community, families prefer hiding it. Although families are satisfied with community-based systems, they need long-term solution, training and financial aid. CONCLUSIONS To reduce the burden, family therapies, education and psychological support should be provided for families, and job opportunities, long-term caregiving services and psychological support should be provided for individuals with schizophrenia.
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Affiliation(s)
- Seda Attepe Özden
- 1 Department of Social Work, Faculty of Health Sciences, Baskent University, Ankara, Turkey
| | - Tarık Tuncay
- 2 Department of Social Work, Hacettepe University, Ankara, Turkey
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13
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Katsuki F, Takeuchi H, Inagaki T, Maeda T, Kubota Y, Shiraishi N, Tabuse H, Kato T, Yamada A, Watanabe N, Akechi T, Furukawa TA. Brief multifamily Psychoeducation for family members of patients with chronic major depression: a randomized controlled trial. BMC Psychiatry 2018; 18:207. [PMID: 29929495 PMCID: PMC6013880 DOI: 10.1186/s12888-018-1788-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/12/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a common and often chronic problem. Patients with chronic MDD often have negative impacts on the health of their families. Family psychoeducation is recognized as part of the optimal treatment for patients with psychotic disorder, and has been shown to reduce the rate of relapse in individuals with schizophrenia and to reduce the burden on their caregivers. Thus, we predict that family psychoeducation has the potential to reduce the burden on the caregivers of patients with chronic MDD. In the present study, we aimed to investigate the effects of brief multifamily psychoeducation (BMP) on the mental health status of family members of patients with chronic MDD. METHODS We conducted a clinical trial consisting of 49 chronic MDD patients and their families. Each family was randomly assigned to either the BMP intervention group or the control group. The intervention group received four BMP sessions, once every two weeks for eight weeks. The control group received one counseling session administered by a nurse. All patients received standard treatment administered by physicians. The primary outcome measurement was the Kessler Screening Scale for Psychological Distress (K6) score of family members at 16- weeks after the first BMP session. Secondary outcomes were depressive symptoms of both family members and patients at multiple time points, as well as family functioning as evaluated by the patients. Intention-to-treat analyses were conducted. RESULTS There was no statistically significant effect of BMP on K6 scores at 16- weeks (mean difference 1.17, 95% confidence interval: - 0.63 to 2.98, P = 0.19). Exploratory analyses revealed that BMP reduced depressive symptoms in family members at 8- weeks (difference = - 3.37, 95%CI -6.32 to - 0.43, P = 0.02) and improved family functioning at multiple time points (Role; 8 W, difference = - 0.13, 95%CI -0.26 to - 0.00, P = 0.04, Affective Responsiveness; 8 W, difference = - 0.24, 95%CI -0.43 to - 0.05, P = 0.01, 32 W, difference = - 0.22, 95%CI -0.41 to - 0.03, P = 0.02, Behavior Control; 16 W, difference = - 0.17, 95%CI -0.34 to - 0.00, P = 0.04). CONCLUSIONS Four BMP sessions did not significantly reduce the psychological distress of family members of patients with chronic MDD. TRIAL REGISTRATION Clinical Trials. gov NCT01734291 , retrospectively registered (Registration date: November 21, 2012).
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Affiliation(s)
- Fujika Katsuki
- Department of Psychiatric and Mental Health Nursing, Nagoya City University School of Nursing, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
| | - Hiroshi Takeuchi
- grid.413410.3Department of Psychiatry, Japanese Red Cross Nagoya Daini Hospital, Myokencho 2-9, Syowa-ku, Nagoya, Japan
| | - Takahiko Inagaki
- 0000 0000 9747 6806grid.410827.8Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa cho, Otsu, Shiga Japan
| | - Tohru Maeda
- 0000 0004 0371 5415grid.411042.2School of Pharmacy, Kinjo Gakuin University, 2-1723 Omori Moriyama-ku, Nagoya, Japan
| | - Yosuke Kubota
- 0000 0001 0728 1069grid.260433.0Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Nao Shiraishi
- 0000 0001 0728 1069grid.260433.0Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Hideaki Tabuse
- Holy Cross Hospital, Kujiri 2431-160, Izumi-cho, Toki, Gifu, Japan
| | - Tadashi Kato
- Aratama Kokoro Clinic, Suyama-cho 1-49, Mizuho-ku, Nagoya, Japan
| | - Atsurou Yamada
- 0000 0001 0728 1069grid.260433.0Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Norio Watanabe
- 0000 0004 0372 2033grid.258799.8Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Tatsuo Akechi
- 0000 0001 0728 1069grid.260433.0Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Toshiaki A. Furukawa
- 0000 0004 0372 2033grid.258799.8Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
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