Principles and results of family therapy in schizophrenia.

There is growing evidence that social factors contribute significantly to the course and outcome in schizophrenia. In particular, the relationship between high EE and schizophrenic relapse has been documented by many investigators. Since 1980, several psychoeducational family management programs have been evaluated showing a significant reduction in relapse when compared to standard psychiatric care. To prevent tardive dyskinesia, alternative medication strategies have been introduced, e.g. low dose and targeted medication. In the Munich treatment study the combined effects of behavioral family management (BFM) and standard dose (SD) or targeted neuroleptic medication TM) on relapse and social functioning of the patient as well as coping and burden of the family have been investigated. N = 51 patients with 73 relatives were randomly assigned to the two groups (BFMSD = 27, BFMTM = 24). Relapse rates at 18 month were: BFSD = 3.9%, BFMTM = 33.8%. In summary, psychoeducational family management in combination with standard dose medication proved to be highly effective in preventing relapse in schizophrenia. These results are in line with findings of anglo-american studies and call for a more widespread application of these new psychosocial approaches in order to provide the best services available for the chronically ill schizophrenic patient and their families.