Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial

IntroductionSchizophrenia is recognized for its severe impact on both patients and caregivers. In a 12-month follow-up randomized clinical trial, we aimed to measure the efficacy of a brief family psychoeducation program in terms of reducing relapse risk and improving medication adherence in patient...

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Main Authors: Arnaud Tessier, Karine Roger, Alexandra Gregoire, Pauline Desnavailles, David Misdrahi
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-06-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1171661/full
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author Arnaud Tessier
Arnaud Tessier
Arnaud Tessier
Karine Roger
Alexandra Gregoire
Pauline Desnavailles
David Misdrahi
David Misdrahi
David Misdrahi
author_facet Arnaud Tessier
Arnaud Tessier
Arnaud Tessier
Karine Roger
Alexandra Gregoire
Pauline Desnavailles
David Misdrahi
David Misdrahi
David Misdrahi
author_sort Arnaud Tessier
collection DOAJ
description IntroductionSchizophrenia is recognized for its severe impact on both patients and caregivers. In a 12-month follow-up randomized clinical trial, we aimed to measure the efficacy of a brief family psychoeducation program in terms of reducing relapse risk and improving medication adherence in patients, as well as reducing caregiver burden, depression and increasing knowledge of the illness.MethodsA total of 25 days of patients with schizophrenia (DSM-IV-TR) and family primary caregivers were recruited in a single regional psychiatric outpatient facility located in Bordeaux. In the active group, caregivers received a psychoeducational intervention consisting of six sessions spread over 1.5 months, while the control group was placed on a waiting list. Sociodemographic, symptom severity (PANSS) and medication adherence (MARS) from patients were assessed at baseline and relapse rates was recorded during the 12 months follow-up period. Caregivers’ burden (ZBI), depression (CES-D), quality of life (S-CGQoL), knowledge of the disease (KAST) and therapeutic alliance (4PAS-C) were assessed at baseline, three and 6 months.ResultsOn the 25 patients included, the mean age was 33.3 years (SD = 9.7) with a mean duration of disease of 7.48 years (SD = 7.1). On the 25 caregivers included, the mean age was 50.6 years (SD = 14.0). Twenty-one were female (84.0%), 12 were married (48.0%) and 11 lived alone (44.0%). For patients, the family psychoeducation intervention significantly reduced the risk of relapse with a significant effect found at 12 months follow-up (p = 0.014). No change was observed on medication adherence. For caregivers, the intervention reduced the burden (p = 0.031), decreased the depression (p = 0.019), and increased the knowledge on schizophrenia (p = 0.024). Analyzes for repeated measures showed a statistically significant difference in therapeutic alliance (p = 0.035).ConclusionAs confirmed by previous studies, the brief multifamily program (consisting of six sessions over a period of 1.5 months) was found to be effective in improving outcomes for caregivers (e.g., burden, depression, knowledge) and patients (e.g., preventing relapse) in the context of routine care. Given its short duration, this program is expected to be easily implementable within the community.Clinical trial registrationhttps://clinicaltrials.gov/, NCT03000985.
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spelling doaj.art-3475017e41d54cd6ada292b6a1c964142023-06-23T10:30:19ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-06-011410.3389/fpsyt.2023.11716611171661Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trialArnaud Tessier0Arnaud Tessier1Arnaud Tessier2Karine Roger3Alexandra Gregoire4Pauline Desnavailles5David Misdrahi6David Misdrahi7David Misdrahi8Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, FranceAquitaine Institute for Cognitive and Integrative Neuroscience, Bordeaux, FranceFondation Fondamental, Créteil, FranceDepartment of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, FranceDepartment of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, FranceDepartment of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, FranceDepartment of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, FranceAquitaine Institute for Cognitive and Integrative Neuroscience, Bordeaux, FranceFondation Fondamental, Créteil, FranceIntroductionSchizophrenia is recognized for its severe impact on both patients and caregivers. In a 12-month follow-up randomized clinical trial, we aimed to measure the efficacy of a brief family psychoeducation program in terms of reducing relapse risk and improving medication adherence in patients, as well as reducing caregiver burden, depression and increasing knowledge of the illness.MethodsA total of 25 days of patients with schizophrenia (DSM-IV-TR) and family primary caregivers were recruited in a single regional psychiatric outpatient facility located in Bordeaux. In the active group, caregivers received a psychoeducational intervention consisting of six sessions spread over 1.5 months, while the control group was placed on a waiting list. Sociodemographic, symptom severity (PANSS) and medication adherence (MARS) from patients were assessed at baseline and relapse rates was recorded during the 12 months follow-up period. Caregivers’ burden (ZBI), depression (CES-D), quality of life (S-CGQoL), knowledge of the disease (KAST) and therapeutic alliance (4PAS-C) were assessed at baseline, three and 6 months.ResultsOn the 25 patients included, the mean age was 33.3 years (SD = 9.7) with a mean duration of disease of 7.48 years (SD = 7.1). On the 25 caregivers included, the mean age was 50.6 years (SD = 14.0). Twenty-one were female (84.0%), 12 were married (48.0%) and 11 lived alone (44.0%). For patients, the family psychoeducation intervention significantly reduced the risk of relapse with a significant effect found at 12 months follow-up (p = 0.014). No change was observed on medication adherence. For caregivers, the intervention reduced the burden (p = 0.031), decreased the depression (p = 0.019), and increased the knowledge on schizophrenia (p = 0.024). Analyzes for repeated measures showed a statistically significant difference in therapeutic alliance (p = 0.035).ConclusionAs confirmed by previous studies, the brief multifamily program (consisting of six sessions over a period of 1.5 months) was found to be effective in improving outcomes for caregivers (e.g., burden, depression, knowledge) and patients (e.g., preventing relapse) in the context of routine care. Given its short duration, this program is expected to be easily implementable within the community.Clinical trial registrationhttps://clinicaltrials.gov/, NCT03000985.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1171661/fullpsychoeducationcaregiversschizophreniarelapseburdendepression
spellingShingle Arnaud Tessier
Arnaud Tessier
Arnaud Tessier
Karine Roger
Alexandra Gregoire
Pauline Desnavailles
David Misdrahi
David Misdrahi
David Misdrahi
Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial
Frontiers in Psychiatry
psychoeducation
caregivers
schizophrenia
relapse
burden
depression
title Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial
title_full Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial
title_fullStr Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial
title_full_unstemmed Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial
title_short Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial
title_sort family psychoeducation to improve outcome in caregivers and patients with schizophrenia a randomized clinical trial
topic psychoeducation
caregivers
schizophrenia
relapse
burden
depression
url https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1171661/full
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