Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T19:27:02.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Schizophrenia: A five-year follow-up of patient outcome following psycho-education for caregivers

Published online by Cambridge University Press:  15 April 2020

S. McWilliams ,
S. Hill ,
N. Mannion ,
A. Fetherston ,
A. Kinsella  and
E. O’Callaghan
S. McWilliams*
Affiliation:
DETECT Early Intervention in Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
S. Hill
Affiliation:
Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
N. Mannion
Affiliation:
Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
A. Fetherston
Affiliation:
DETECT Early Intervention in Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland
A. Kinsella
Affiliation:
DETECT Early Intervention in Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland
E. O’Callaghan
Affiliation:
DETECT Early Intervention in Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland Department of Psychiatry, University College Dublin, Donnybrook, Dublin 4, Ireland
*
* Corresponding author. Tel.: +35312366730; fax: +35312366739. E-mail address:stephen.mcwilliams@sjog.ie (S. McWilliams).
Get access

Abstract

Introduction

There is evidence that psycho-education courses for caregivers of individuals with schizophrenia improve the short-term outcome of the condition. However, most of the outcome studies are limited to two-year follow-up.

Materials and methods

This study is a five-year retrospective case-control follow-up of an original cohort of 63 patients and their 101 caregivers who completed a six-week Caregiver Psycho-education Programme (CPP) for schizophrenia and psychosis between 2002 and 2005, and 60 controls, matched for age, gender and severity of their psychotic illness.

Results

Patients whose caregivers learned more from the six-week psycho-education course had a significantly longer time to relapse (P = 0.04) and a significantly shorter length of stay during their first relapse (P < 0.05). Patients whose caregivers attended the six-week psycho-education course (regardless of how much the caregivers learned) had a significantly better outcome than controls. This included a significantly smaller number of relapses (P < 0.01), longer time to relapse (P < 0.01), shorter length of stay during their first relapse (P < 0.01) and smaller number of bed days over five years (P < 0.01). The odds ratio of controls relapsing, although insignificant at one year, was 4.13 (1.85–9.21) at five years. Outcome was not affected by either the numbers of caregivers attending for each patient, or caregiver gender.

Discussion and conclusions

This study, which is among the first to examine outcome over five years, supports the efficacy of psycho-education for caregivers in improving outcome for patients. Caregivers should be encouraged to take up psycho-education where it is available.

Keywords

SchizophreniaPsychosisCaregiverGenderPsycho-educationKnowledge
Type
Original article
Information
European Psychiatry , Volume 27 , Issue 1 , January 2012 , pp. 56 - 61
Copyright
Copyright © Elsevier Masson SAS 2012

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

American Psychiatric Association work group on schizophrenia. Practice guideline for the treatment of patients with schizophrenia. 2nd Ed. 2004.Google Scholar
Argimon, JMLimon, EVila, JCabezas, CHealth-related quality of life in caregivers of patients with dementia. Fam Pract. 2004; 21(4): 454–457CrossRefGoogle ScholarPubMed
Bauml, JPitschel-Walz, GVolz, AEngel, RRKesslin, WPsychoeducation in schizophrenia: 7-year follow-up concerning rehospitalisation and days in hospital in the Munich Psychosis Information Project Study. J Clin Psychiatry. 2007; 68(6): 854–861CrossRefGoogle Scholar
Bernhard, BSchaub, AKummler, PDittmen, SSeverus, ESeemuller, F, et al.Impact of cognitive psycho-educational interventions in bipolar patients and their relatives. Eur Psychiatry. 2006;21:81–86CrossRefGoogle Scholar
Bertelsen, MJeppensen, PPetersen, LThorup, AOhlenschlaeger, Jle Quach, P, et al.Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness. Arch Gen Psychiatry. 2008;65:762–771CrossRefGoogle ScholarPubMed
Birchwood, MSmith, JCochrane, RSpecific and non-specific effects of educational intervention for families living with schizophrenia. A comparison of three methods. Br J Psychiatry. 1992;160:806–814CrossRefGoogle ScholarPubMed
Burns, AThe burden of Alzheimer's disease. Int J Neuropsychopharmacol. 2000; 3(7): 31–38CrossRefGoogle ScholarPubMed
Carmichael, FCharles, SThe opportunity costs of informal care: does gender matter?. J Health Econ. 2003; 22(5): 781–803CrossRefGoogle ScholarPubMed
Cassidy, EHill, SO’Callaghan, EEfficacy of psycho-educational intervention on improving relatives’ knowledge about schizophrenia and reducing rehospitalisation. Eur Psychiatry. 2001; 16(8): 446–450CrossRefGoogle Scholar
Donaldson, CBurns, ABurden of Alzheimer's disease: helping the patient and caregiver. J Geriatr Psychiatry Neurol. 1999; 12(1): 21–28CrossRefGoogle ScholarPubMed
Donaldson, CTarrier, NBurns, ADeterminants of carer stress in Alzheimer's disease. Int J Geriatr Psychiatry. 1998; 13(4): 248–2563.0.CO;2-0>CrossRefGoogle ScholarPubMed
Foldemo, AGullberg, MEk, ACBogren, LQuality of life and burden in parents of outpatients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2005; 40(2): 133–138CrossRefGoogle ScholarPubMed
Gafoor, RNitsch, DMcCrone, PCraig, TKJGarety, PAPower, P, et al.Effect of early intervention on 5-year outcome in non-affective psychosis. Br J Psychiatry. 2010;196:372–376CrossRefGoogle ScholarPubMed
Hornung, WPFeldmann, RKlingberg, SBuchkremer, GReker, TLong-term effects of a psychoeducational psychotherapeutic intervention for schizophrenic outpatients and their key-persons–results of a five-year follow-up. Eur Arch Psychiatry Clin Neurosci. 1999; 249(3): 162–167CrossRefGoogle ScholarPubMed
Jorm, AFBlewitt, KAGriffiths, KMKitchener, BAParslow, RAMental health first aid responses of the public: results from an Australian national survey. BMC Psychiatry. 2005;5(1):9CrossRefGoogle ScholarPubMed
Lehman, AFSteinwachs, DMSurvey co-investigators of the PORT project. Patterns of usual care for schizophrenia: initial results from the Schizophrenia Patient Outcomes Research Team (PORT). Schizophr Bull. 1998;24:11–20CrossRefGoogle Scholar
Magliano, LFiorillo, AFadden, GGair, FEconomou, MKallert, T, et al.Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: preliminary results of a study funded by the European Commission. World Psychiatry. 2005; 4(1): 45–49Google ScholarPubMed
Mari, JJStreiner, DLAn overview of family interventions and relapse on schizophrenia: Meta-analysis of research findings. Psychol Med. 1994;24:565–578CrossRefGoogle ScholarPubMed
McFarlane, WRLukens, ELink, BDushay, RDeakins, SANewmark, M, et al.Multiple-family groups and psycho-education in the treatment of schizophrenia. Arch Gen Psychiatry. 1995;52:679–687CrossRefGoogle Scholar
McWilliams, SHill, SMannion, NKinsella, AO’Callaghan, ECaregiver psychoeducation for schizophrenia: Is gender important?. Eur Psychiatry. 2007; 22(5): 323–327CrossRefGoogle ScholarPubMed
Miklowitz, DJAxelson, DABirmaher, BGeorge, ELTaylor, DOSchneck, CD, et al.Family-focussed treatment for adolescents with bipolar disorder–results of a 2-year randomized trial. Arch Gen Psychiatry. 2008; 65(9): 1053–1061CrossRefGoogle Scholar
Montero, IMasanet, MLacruz, MBellver, FAsencio, AGarcia, EFamily intervention in schizophrenia: long-term effect on main caregivers. Actas Esp Psiquiatr. 2006; 34(3): 169–174Google ScholarPubMed
Mueser, KTMcGurk, SRSchizophrenia. Lancet. 2004; 363(9426): 2063–2072CrossRefGoogle ScholarPubMed
National Collaborating Centre for Mental Health commissioned by the National Institute of Health and Clinical Excellence (NICE). Core interventions in the treatment and management of schizophrenia in primary and secondary care (update), 2009. Guideline 82; www.nice.org.uk.Google Scholar
Paccaloni, MPozzan, TZimmermann, CBeing informed and involved in treatment: what do psychiatric patients think? A review. Epidemiol Psichiatr Soc. 2004; 13(4): 270–283CrossRefGoogle ScholarPubMed
Pekkala, EMerinder, L Psycho-education for schizophrenia. Cochrane Database Syst Rev. 4 2006 CD002831Google Scholar
Petersen, LJeppesen, PThorup, AAbel, MBOqhlenschlaeger, JChristensen, TO, et al.A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness. BMJ. 2005;331:602–605CrossRefGoogle ScholarPubMed
Pharoah, FMRathbone, JMari, JJStreiner, D Family intervention for schizophrenia. Cochrane Database Syst Rev. 3 2006 CD000088CrossRefGoogle Scholar
Pitschel-Walz, GLeucht, SBauml, JKissling, WEngel, RRThe effect of family interventions on relapse and rehospitalisation in schizophrenia–a meta-analysis. Schizophr Bull. 2001; 27(1): 73–92CrossRefGoogle Scholar
Rummel-Kluge, CPitschel-Walz, GKissling, WA fast implementable psychoeducation program for schizophrenia. Psychiatr Serv. 2007;58(9):1226CrossRefGoogle Scholar
Schmid, RSpiessl, HCording, CBetween responsibility and delimitation: emotional distress of caregivers. Psychiatr Prax. 2005; 32(6): 272–280CrossRefGoogle ScholarPubMed
Sellwood, WBarrowclough, CTarrier, NQuinn, JMainwaring, JLewis, SNeeds-based cognitive behavioural family intervention for carers of patients suffering from schizophrenia: 12-month follow-up. Acta Psychiatr Scand. 2001;104:346–355CrossRefGoogle ScholarPubMed
Smith, JVBirchwood, MJSpecific and non-specific effects of educational intervention with families living with a schizophrenic relative. Br J Psychiatry. 1987;150:645–652CrossRefGoogle ScholarPubMed
Stevens, JApplied multivariate statistics for the social sciences. 3rd Ed. Malwah, NJ: Lawrence Erlbaum; 1996.Google Scholar
Tarrier, NBarrowclough, CPorceddu, KFitzpatrick, EThe Salford Family Intervention Project: Relapse rates of schizophrenia at five and eight years. Br J Psychiatry 1994; 165: 829–832CrossRefGoogle ScholarPubMed
Tarrier, NLewis, SHaddock, GBentall, RDrake, RKinderman, P, et al.Cognitive-behavioural therapy in first-episode and early schizophrenia. 18-month follow-up of a randomised controlled trial. Br J Psychiatry 2004; 184: 231–239CrossRefGoogle ScholarPubMed
Tennakoon, LAFannon, DDoku, VO’Ceallaigh, SSoni, WSantamaria, M, et al.Experience of caregiving: relatives of people experiencing a first episode of psychosis. Br J Psychiatry 2000; 177: 529–533CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.