Evidence-Based Practice Unit, Anna Freud Centre, University College London, London, UK.
Centre for Longitudinal Studies, University College London, London, UK.
Eur Child Adolesc Psychiatry. 2024 Sep;33(9):3203-3246. doi: 10.1007/s00787-024-02380-3. Epub 2024 Feb 23.
Several interventions have been developed to support families living with parental mental illness (PMI). Recent evidence suggests that programmes with whole-family components may have greater positive effects for families, thereby also reducing costs to health and social care systems. This review aimed to identify whole-family interventions, their common characteristics, effectiveness and acceptability. A systematic review was conducted according to PRISMA 2020 guidelines. A literature search was conducted in ASSIA, CINAHL, Embase, Medline, and PsycINFO in January 2021 and updated in August 2022. We double screened 3914 abstracts and 212 papers according to pre-set inclusion and exclusion criteria. The Mixed Methods Appraisal Tool was used for quality assessment. Quantitative and qualitative data were extracted and synthesised. Randomised-control trial data on child and parent mental health outcomes were analysed separately in random-effects meta-analyses. The protocol, extracted data, and meta-data are accessible via the Open Science Framework ( https://osf.io/9uxgp/ ). Data from 66 reports-based on 41 independent studies and referring to 30 different interventions-were included. Findings indicated small intervention effects for all outcomes including children's and parents' mental health (d = -0.017, -027; d = -0.14, -0.16) and family outcomes. Qualitative evidence suggested that most families experienced whole-family interventions as positive, highlighting specific components as helpful, including whole-family components, speaking about mental illness, and the benefits of group settings. Our findings highlight the lack of high-quality studies. The present review fills an important gap in the literature by summarising the evidence for whole-family interventions. There is a lack of robust evidence coupled with a great need in families affected by PMI which could be addressed by whole-family interventions. We recommend the involvement of families in the further development of these interventions and their evaluation.
已经开发了几种干预措施来支持有父母精神疾病（PMI）的家庭。最近的证据表明，具有全家庭组成部分的方案可能对家庭产生更大的积极影响，从而也降低了卫生和社会保健系统的成本。本综述旨在确定全家庭干预措施、它们的共同特征、效果和可接受性。根据 PRISMA 2020 指南进行了系统综述。2021 年 1 月在 ASSIA、CINAHL、Embase、Medline 和 PsycINFO 进行了文献检索，并于 2022 年 8 月进行了更新。我们根据预先设定的纳入和排除标准对 3914 篇摘要和 212 篇论文进行了双次筛选。使用混合方法评估工具进行质量评估。提取并综合了定量和定性数据。分别对儿童和父母心理健康结果的随机对照试验数据进行了随机效应荟萃分析。方案、提取的数据和元数据可通过开放科学框架（https://osf.io/9uxgp/）获取。共有 66 份报告（基于 41 项独立研究）的数据被纳入，涉及 30 种不同的干预措施。结果表明，所有结果都显示出干预的小效应，包括儿童和父母的心理健康（d=-0.017，-027；d=-0.14，-0.16）和家庭结果。定性证据表明，大多数家庭都体验到全家庭干预措施是积极的，强调了一些特定的组成部分是有帮助的，包括全家庭组成部分、谈论精神疾病以及小组设置的好处。我们的研究结果强调了高质量研究的缺乏。本综述通过总结全家庭干预措施的证据，填补了文献中的一个重要空白。受 PMI 影响的家庭对此类干预措施的需求很大，但缺乏强有力的证据，这些干预措施可以满足这一需求。我们建议让家庭参与这些干预措施的进一步发展和评估。
