Mino Y, Tsuda T, Shigemi J, Tanihara S, Aoyama H, Babazono A
Department of Hygiene & Preventive Medicine, Okayama University Medical School.
Nihon Koshu Eisei Zasshi. 1995 May;42(5):301-12.
The present study reviews eight series of trials on psycho-social family intervention for schizophrenia based on Expressed Emotion (EE). All studies used randomized controlled trials (RCT) except one which was non-randomized controlled trial. The relapse risk ratios (intervention/control) for 9-12 months after discharge were 0 to .73 and for 24 months were .20 to .57. Taking into account the shortcomings of the studies, the authors conclude that psycho-social family intervention based on EE is effective in preventing schizophrenic relapse, and discuss four important issues: 1) For effective family intervention, methods for Japanese patients should be established from a trans-cultural view point; 2) The interaction of two or more therapeutic measures should be evaluated quantitatively; 3) The mechanisms of schizophrenic relapse prevention through family psycho-social intervention should be explored. A psycho-physiological study including skin conductance measurement is promising; 4) The authors point out the ethical aspect of family intervention, and discuss the importance of informed consent and the need to place emphasis on family's needs.
本研究回顾了八项基于情感表达（EE）的针对精神分裂症患者的心理社会家庭干预试验系列。除一项为非随机对照试验外，所有研究均采用随机对照试验（RCT）。出院后9至12个月的复发风险比（干预组/对照组）为0至0.73，24个月时为0.20至0.57。考虑到这些研究的不足之处，作者得出结论，基于EE的心理社会家庭干预在预防精神分裂症复发方面是有效的，并讨论了四个重要问题：1）为了进行有效的家庭干预，应从跨文化角度为日本患者建立相应方法；2）应定量评估两种或更多治疗措施的相互作用；3）应探索通过家庭心理社会干预预防精神分裂症复发的机制。一项包括皮肤电导率测量的心理生理学研究很有前景；4）作者指出了家庭干预的伦理问题，并讨论了知情同意的重要性以及强调家庭需求的必要性。
