Department of Psychiatry, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Soc Psychiatry Psychiatr Epidemiol. 2022 Jul;57(7):1357-1364. doi: 10.1007/s00127-022-02227-9. Epub 2022 Feb 12.
Schizophrenia has a significant and lasting impact on the quality of life of patients and their families and is a leading cause of disability globally. Family interventions can be beneficial and may be particularly appropriate in settings with limited resources. We conducted an exploratory trial testing the effectiveness of a multifamily group intervention, which draws on the traditions of psychoeducation and trialogue, for improving the quality of life of patients with schizophrenia in Bosnia and Herzegovina.
We conducted an exploratory, randomised controlled trial with patients with schizophrenia attending an outpatient clinic in Sarajevo. Our primary outcome was improved quality of life at 6-month follow-up. Secondary outcomes included objective social outcomes, psychiatric symptoms and psychiatric hospitalisation measured at 6 and 12 months. Experiences of participants were assessed in post-intervention interviews.
72 patients were randomly assigned to either one of six multifamily groups or treatment as usual. Follow-up assessments were completed with 53 patients (74%) at 6 months and 55 patients (76%) at 12 months. The intervention significantly improved quality of life at 6 months (Cohen's d = 0.78, F = 6.37, p = 0.016) and 12 months (d = 1.08, F = 17.92, p < 0.001), compared with treatment as usual. Re-hospitalisation rates at 6 months and symptom levels also improved significantly whilst changes in other secondary outcomes failed to reach statistical significance.
These findings suggest multifamily groups can be effective for improving the quality of life of patients with schizophrenia in Bosnia and Herzegovina. Further research is required to assess how multifamily groups may be scaled up in similar settings with limited resources.
精神分裂症对患者及其家庭的生活质量有重大且持久的影响，是全球导致残疾的主要原因。家庭干预可能有益，在资源有限的环境中可能尤其合适。我们开展了一项探索性试验，以检验一种借鉴心理教育和三人对话传统的多家庭团体干预对改善波斯尼亚和黑塞哥维那精神分裂症患者生活质量的效果。
我们开展了一项探索性、随机对照试验，纳入萨拉热窝一家门诊就诊的精神分裂症患者。我们的主要结局是在 6 个月随访时生活质量改善。次要结局包括在 6 个月和 12 个月时测量的客观社会结局、精神病症状和精神病住院治疗。在干预后访谈中评估参与者的体验。
72 名患者被随机分配至 6 个多家庭组中的 1 个或接受常规治疗。在 6 个月时，53 名患者（74%）和 12 个月时 55 名患者（76%）完成了随访评估。与常规治疗相比，干预在 6 个月（Cohen's d=0.78，F=6.37，p=0.016）和 12 个月（d=1.08，F=17.92，p<0.001）时显著改善了生活质量。6 个月时的再住院率和症状水平也显著改善，而其他次要结局的变化未达到统计学意义。
这些发现表明，多家庭团体可以有效改善波斯尼亚和黑塞哥维那精神分裂症患者的生活质量。需要进一步研究以评估多家庭团体在资源有限的类似环境中如何扩大规模。
