Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong.
The University of Hong Kong, Hong Kong.
Int J Environ Res Public Health. 2023 Jan 5;20(2):1018. doi: 10.3390/ijerph20021018.
In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program.
We randomly assigned 65 caregivers of young adults with psychosis to MBFPE ( = 33) or an ordinary family psychoeducation (FPE) program ( = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes.
Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers' outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program ( = 8.268, = 0.012, = 1.484). They also reported a larger reduction in over-involvement of their caregivers ( = 4.846, = 0.044, = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement.
A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size.
在这项研究中，我们通过多中心随机对照试验，调查了基于正念的家庭心理教育（MBFPE）方案对过去三年内首发精神病且发病年龄在 3 年以内的患者照顾者和年轻成年患者心理健康结局的影响。我们还研究了人际正念、表达情绪和不依恋三种潜在中介效应对该方案的影响。
我们随机分配了 65 名精神病年轻成年患者的照顾者，接受 MBFPE（n=33）或普通家庭心理教育（FPE）方案（n=32）；其中，18 名康复中的年轻成年患者也参与了结局评估。
意向性治疗分析。MBFPE 和 FPE 方案均未发现任何照顾者结局的时间×组交互作用效应。然而，接受 MBFPE 方案的精神病年轻成年患者报告的康复水平高于接受普通 FPE 方案的患者（均差=8.268，P=0.012，效应量=1.484）。他们还报告了照顾者过度卷入程度的更大降低（均差=4.846，P=0.044，效应量=1.136），表明 MBFPE 比 FPE 更能促进康复和减少过度卷入。
简短的心理教育方案可能不会减轻近期首发精神病患者照顾者的负担或改善其心理健康结局。然而，将正念融入常规家庭心理教育方案可能会降低照顾者的表达情绪，特别是过度卷入。进一步的研究应该通过使用严格的研究设计和充足的样本量，探索心理教育方案如何通过减轻负担和表达情绪来减少精神病对家庭的影响，从而产生可持续的效果。
