[Does psychoeducational family intervention improve outcome of schizophrenia?].

BACKGROUND

Psychoeducational family intervention for schizophrenia was developed to reduce stress levels in families in order to improve outcome.

MATERIAL AND METHODS

Systematic reviews and search in databases (until February 2002, "Family" and "Schizophrenia") were used to find randomized controlled studies of effect.

RESULTS

We found seven studies of short-term family treatment, 15 studies of long-term treatment comparing it to individual therapy, and seven studies comparing family treatment modalities. Long-term family intervention reduces the risk of psychotic relapse to about the half within the first two years. These methods also shorten hospital stays, improve compliance with medication, patients' social functioning and relatives' well-being, and they seem to be cost-effective. Single and group family therapies including patients are equally efficacious. Relatives' groups do not seem to improve outcome. Several factors, such as expressed emotion and duration of illness, modify the effects and should be taken into account.

INTERPRETATION

In Norway there is a need for systematic training of mental health workers in these methods. Family intervention should be offered to all persons with schizophrenia who are in frequent contact with relatives.