Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
BMC Psychiatry. 2019 Sep 2;19(1):263. doi: 10.1186/s12888-019-2252-y.
This study examined the effects of the standard model of family psychoeducation (SM-FPE) in Japan on the mental health of relatives who care for young patients with a psychotic disorder.
Stratified by recent-onset/chronic psychosis, 74 caregivers of outpatients aged 30.1 years (mean) were randomly assigned to receive TAU (treatment as usual) alone or TAU plus SM-FPE. All outcomes were measured at baseline, at the end of the intervention (10 weeks), and 1 month post-intervention (14 weeks). The primary outcome was the trait anxiety of caregivers at 14 weeks. Secondary outcomes included caregivers' state anxiety, psychological distress, care burden, and expressed emotion. Integrating these secondary outcomes, a conceptual framework of caregivers' health state was assessed via structural equation modelling.
Compared with TAU alone, SM-FPE plus TAU did not significantly improve all caregivers' individual outcomes. Direct effects of the intervention were observed in the caregivers of chronic patients as significant improvements of their overall mental health state at 10 weeks, which indirectly continued until 14 weeks. However, such intervention effects were not observed in the caregivers of recent-onset patients.
The lack of effectiveness in the recent-onset stage suggests that the usefulness of the SM-FPE needs to be corroborated by further research.
The study protocol was retrospectively registered at ClinicalTrials.gov (registration number: NCT01731977; date of registration: 22 November 2012).
本研究考察了日本标准家庭心理教育模式（SM-FPE）对照顾年轻精神病患者的亲属心理健康的影响。
根据首发/慢性精神病分层，74 名年龄为 30.1 岁（平均值）的门诊患者照顾者被随机分配接受 TAU（常规治疗）或 TAU 加 SM-FPE。所有结果均在基线、干预结束时（10 周）和干预后 1 个月（14 周）进行测量。主要结局为 14 周时照顾者的特质焦虑。次要结局包括照顾者的状态焦虑、心理困扰、照顾负担和表达的情感。通过结构方程模型评估整合这些次要结局的照顾者健康状况的概念框架。
与 TAU 相比，SM-FPE 加 TAU 并没有显著改善所有照顾者的个体结局。干预的直接影响在慢性患者的照顾者中观察到，他们的整体心理健康状态在 10 周时显著改善，这种影响间接持续到 14 周。然而，在首发患者的照顾者中没有观察到这种干预效果。
在首发阶段缺乏有效性表明，需要进一步研究来证实 SM-FPE 的有效性。
研究方案在 ClinicalTrials.gov 上进行了回顾性注册（注册号：NCT01731977；注册日期：2012 年 11 月 22 日）。
