DETECT Early Intervention in Psychosis Service, DETECT, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland.
Eur Psychiatry. 2010 Jan;25(1):33-8. doi: 10.1016/j.eurpsy.2009.08.006. Epub 2009 Nov 18.
International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes.
Caregivers of people with first-episode psychosis completed a 23-item adapted version of the self-report Family Questionnaire (KQ) and a 17-item adapted version of the self-report Drug Attitudes Inventory (DAI) before and after the six-week DETECT Information and Support Course (DISC). Using a Generalised Linear Repeated Measures Model, we analyzed the differences in proportions of correct answers before and after the programme.
Over a 24-month study period, 31 caregivers (13 higher socioeconomic; 13 lower socioeconomic; five unspecified socioeconomic; 19 female; 12 male) participated in the DISC programme and completed inventories before and after the course. Knowledge of psychosis and specific knowledge of medication treatment improved among caregivers overall (p<.01; effect sizes 0.78 and 0.94 respectively). There were no significant gender or socioeconomic differences in any improvement.
This study confirms that caregiver psychoeducation specifically for first-episode psychosis directly improves knowledge of the illness overall and, in particular, knowledge of medication. Gender is not a factor in this, while the lack of any socioeconomic differences dispels the myth that patients in lower socioeconomic groups are disadvantaged because their caregivers know less.
针对首发精神病的国际最佳实践指南建议提供多家庭群体的心理教育。虽然有大量证据表明它们在反复发作的精神病中有效，但针对首发精神病的证据很少。我们试图确定专门针对首发精神病的六周照顾者心理教育计划是否能提高照顾者的知识和态度。
首发精神病患者的照顾者在参加 DETECT 信息和支持课程（DISC）的六周前和后，完成了自我报告家庭问卷（KQ）的 23 项改编版和自我报告药物态度量表（DAI）的 17 项改编版。使用广义线性重复测量模型，我们分析了计划前后正确答案比例的差异。
在 24 个月的研究期间，31 名照顾者（13 名高社会经济；13 名低社会经济；5 名社会经济状况不详；19 名女性；12 名男性）参加了 DISC 计划，并在课程前后完成了问卷调查。总体而言，照顾者对精神病的认识和对药物治疗的具体认识有所提高（p<.01；效应大小分别为 0.78 和 0.94）。在任何方面的改善中，都没有明显的性别或社会经济差异。
本研究证实，专门针对首发精神病的照顾者心理教育直接提高了对疾病的总体认识，特别是对药物治疗的认识。性别不是一个因素，而缺乏任何社会经济差异消除了一个神话，即社会经济地位较低的患者处于劣势，因为他们的照顾者知道的较少。
