Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T13:14:36.997Z Has data issue: false hasContentIssue false
  • English
  • Français

Randomised controlled trial of a behavioural family intervention: 1 year and 11-years follow-up

Published online by Cambridge University Press:  18 May 2011

Franco Veltro ,
Lorenza Magliano ,
Pierluigi Morosini ,
Elvira Fasulo ,
Giuseppe Pedicini ,
Isabella Cascavilla  and
Ian Falloon
Franco Veltro
Affiliation:
Dipartimento di Salute Mentale di Campobasso, Campobasso
Lorenza Magliano
Affiliation:
Istituto di Psichiatria, Seconda Facoltà di Medicina di Napoli, Napoli
Pierluigi Morosini*
Affiliation:
Istituto Superiore di Sanità, Roma
Elvira Fasulo
Affiliation:
Dipartimento di Salute Mentale di Benevento, Benevento
Giuseppe Pedicini
Affiliation:
Dipartimento di Salute Mentale di Benevento, Benevento
Isabella Cascavilla
Affiliation:
Istituto Superiore di Sanità, Roma
Ian Falloon
Affiliation:
Department of Psychiatry, University of Auckland, Auckland
*
Address for correspondence: Professor P. Morosini, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma. E-mail: morosini@iss.it
Get access Rights & Permissions [Opens in a new window]

Summary

Aim – To test the efficacy of a Behavioural Family Therapy (BFT) in a routine setting, both short and long term, of a community mental health service (CMHS). Methods – In a randomised clinical trial 24 patients with a diagnosis of schizophrenia, as confirmed by PSE-IX, were assigned to the BFT according to Falloon (n = 12) or to individual usual treatment (n = 12). They were assessed before and at the end of the active treatment (after one year), and after an 11-years follow-up with compared on basic indicators (hospitalisations, length of stay, drop-out rate) and standardised instruments of psychopathological symptoms, social functioning, family burden. Results – At one-year follow-up clinical important and statistically significant differences were observed for psychotic positive symptoms (p<0.01), self-care (p<0.01), autonomy in daily life (p<0.001), subjective/objective family burden (p<0.001). Other psychosocial variables showed positive outcomes non reaching statistical significance. At the 11-year follow-up, marked differences were observed only in hospitalisations and drop-outs. Conclusions – The BFT was rather easy to implement in a CMHS and very cost effective. However, as it has been shown in other studies, to keep all the benefits a consistent program of monitoring with booster sessions is essential.

Declaration of Interest: in the last 2 years, none of the authors has had any interest or he/she has received any form of support, including that from drug companies and “honoraria” for lectures and consultancies, potentially in conflict with this scientific work.

Keywords

psychoeducationfamilyschizophreniaefficacyRCT
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 15 , Issue 1 , March 2006 , pp. 44 - 51
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Barbato, A. & D'avanzo, B. (2000). Family interventions in schizophrenia and related disorders: a critical review of clinical trials. Acta Psychiatrica Scandinavia! 102, 81–97.CrossRefGoogle ScholarPubMed
Bentsen, H. (2003). Does psychoeducational family intervention improve outcome of schizophrenia? Tidsskr Nor Laegeforen 123, 2571–2574.Google ScholarPubMed
Bustillo, J.R., Lauriello, J., Horan, W.P. & Keith, S.J. (2001). The psychosocial treatment for schizophrenia: an update. American Journal of Psychiatry 158, 163–175.CrossRefGoogle ScholarPubMed
Falloon, I.R.H. (1994). Intervento Psicoeducativo Integrato in Psichiatria. Edizioni Erickson: Trento.Google Scholar
Falloon, I.R.H. (2003). Family interventions for mental disorders: efficacy and effectiveness. World Psychiatry 2, 20–28.Google ScholarPubMed
Falloon, I.R.H., Boyd, J.L., McGill, C.W., Razani, J., Moss, M.B. & Gilderman, A.M. (1982). Family management in the prevention of exacerbation of schizophrenia: a control study. New England Journal of Medicine 306, 1437–1440.CrossRefGoogle Scholar
Falloon, I.R.H., Montero, I., Sungur, M., Mastroeni, A., Malm, U., Economou, M., Grawe, R., Harangozo, J., Mizuno, M., Murakami, M., Hager, B., Held, T., Veltro, F., Gedye, R., & OTP Collaborative Group (2004). Implementation of evidence-based treatment for schizophrenic disorders: two-year outcome of an international field trial of optimal treatment. World Psychiatry 3, 104–109.Google ScholarPubMed
Fleiss, J.L. (1981). Statistical Methods for Rates and Proportions. John Wiley and Sons: New York.Google Scholar
Hogarty, G.E. & Anderson, C.M. (1986). Medication, family psychoeducation, and social skills training: first-year relapse results of a controlled study. Psychopharmacology Bulletin 22, 860–862.Google ScholarPubMed
Jeppesen, P., Petersen, L., Thorup, A., Abel, M.B., Oehlenschlaeger, J., Christenses, T.O., Krarup, G., Hemmingsen, R., Jorgensen, P. & Nordentoft, M. (2005). Integrated treatment of first-episode psychosis: effect of treatment on family burden: OPUS trial. British Journal of Psychiatry 48, Suppl., 85–90.CrossRefGoogle ScholarPubMed
Lenior, M.E., Dingemans, P.M., Linszen, D.H., de Haan, L. & Schene, A.H. (2001). Social functioning and the course of early-onset schizophrenia: five-year follow-up of a psychosocial intervention. British Journal of Psychiatry 179, 53–58.CrossRefGoogle ScholarPubMed
Liddle, P.F. (1987). The symptoms of chronic schizophrenia: a re-examination of the positive-negative dicothomy. British Journal of Psychiatry 151, 145–151.CrossRefGoogle Scholar
Magliano, L., Veltro, F. & Morosini, P.L. (1993). L'approccio psicoeducativo territoriale: un'esperienza di formazione integrata per gli operatori di un servizio di salute mentale. Rivista Sperimentale di Freniatria 4, 562–579.Google Scholar
Maj, M. (1990). Il trattamento a lungo termine nel paziente schizofrenico: come impostarlo in modo da favorire il lavoro riabilitativo. In Riabilitazione Psicosociale (ed. Burti, L., Siani, R. e Siciliani, O.). Franco Angeli: Milano.Google Scholar
McDonell, M.G., Short, R.A., Berry, C.M. & Dyck, D.G. (2003). Burden in schizophrenia caregivers: impact of family psychoeducational and awereness of patient suicidality. Family Process 42, 91–103.CrossRefGoogle Scholar
McFarlane, W.R., Lukens, E., Link, B., Dushay, R., Deakins, S.A., Newmark, M., Dunne, E.J., Horen, B. & Toran, J. (1995). Multiple family group and psychoeducation in the treatment of schizophrenia. Archives of General Psychiatry 52, 679–687.CrossRefGoogle ScholarPubMed
Mclntosh, A. & Lawrie, S. (2004) Schizophrenia. Clinical Evidence. 12, 1502–1533.Google Scholar
Michielin, P. (2004). Trattamenti cognitivo-comportamentali della schizofrenia. In Mente e Cervello (ed. Galeazzi, A. e Meazzini, P.). Giunti Editore: Firenze.Google Scholar
Morosini, P., Roncone, R., Veltro, F., Palomba, U. & Casacchia, M. (1991). Routine assessment tool in psychiatry: a questionnaire on family attitudes and burden. Italian Journal of Psychiatry and Behavioural Sciences 1, 95–101.Google Scholar
Morosini, P., Gigantesco, A., Mazzarda, A. & Gibaldi, L. (2003). HoNOS-Roma: una versione ampliata, personalizzabile e che facilita la compilazione ripetuta nel tempo dello strumento HoNOS. Epidemiologia e Psichiatria Sociale 12, 53–62.CrossRefGoogle ScholarPubMed
Pekkala, E. & Merinder, L. (2002). Psychoeducation for schizophrenia. Cochrane Database of Systematic Reviews, Issue 2.CrossRefGoogle Scholar
Pharoah, F.M., Rathbone, J., Mari, J.J. & Streiner, D. (2005). Family intervention for schizophrenia. Cochrane Database of Systematic Reviews, Issue 4.Google Scholar
Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Orbach, G. & Morgan, C. (2002). Psychological treatments in schizophrenia: I. Meta analysis of family intervention and cognitive-behaviour therapy. Psychological Medicine 32, 763–782.CrossRefGoogle ScholarPubMed
Roncone, R. & Casacchia, M. (2003). I trattamenti psicoeducaziona-li con il coinvolgimento delle famiglie nella schizofrenia. In L'Approccio Multimodale nella Riabilitazione Psichiatrica (ed. De Bernardino, C.). McGraw Hill: Milano.Google Scholar
Tarrier, N., Barrowclough, C., Vaughn, C., Bamrah, J.S., Porceddu, K., Watts, S. & Freeman, H. (1989). Community management of schizophrenia. A two-year follow-up of a behavioural intervention with families. British Journal of Psychiatry 154, 625–628.CrossRefGoogle ScholarPubMed
Veltro, F., Morosini, P.L., Cerreta, A., Sannino, A. & Vega, M.L. (1989). Studio di riproducibilità di un questionario (QPD) per la valutazione della disabilità sociale nel paziente psichiatrico. Neurologia, Psichiatria, Scienze Umane 9, 133–142.Google Scholar
Wing, J.K., Cooper, J.E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
World Health Organization (1978). Glossary and Guide to the Classification of Mental Disorders in Accordance with the Ninth Revision of the International Classifications of Disease. WHO: Geneva.Google Scholar