Abstract

Introduction: Recent research in Western countries has indicated that family interventions in schizophrenia and other psychotic disorders can reduce patient relapse and improve medication compliance. Few studies have addressed Chinese and Asian populations. This study tested the long-term effects of a 9-month family-led mutual support group for Chinese people with schizophrenia in Hong Kong, compared with psycho-education and standard psychiatric care.Methods: A randomized controlled trial of Chinese families of patients with recent-onset psychosis (≤5 years of illness) was conducted between August 2012 and January 2017, with a 4-year follow-up. Two hundred and one Chinese families of adult outpatients with recent-onset psychosis were randomly selected from the computerized patient lists and randomly assigned to either mutual support, psycho-education, or standard care group (n = 70 per group). Family caregivers were mainly the parent, spouse, or child of the patients. Mutual support and psycho-education group consisted of 16 two-hour group sessions and patients participated in three sessions. The standard care group and the two treatment groups received the routine psychiatric outpatient care.Results: Patients and families in the mutual support group reported consistently greater improvements in overall functioning [family functioning, F(2, 203) = 8.13, p = 0.003; patient functioning, F(2, 203) = 6.01, p = 0.008] and reductions in duration of hospitalizations [F(2, 203) = 6.51, p = 0.005] over the 4-year follow-up. There were not any significant increases of medication dosages or service use by both the family support and psycho-education groups over time.Conclusions: The peer-led family support group can be an effective psychosocial intervention in early psychosis indicating long-term benefits on both patient and family functioning and re-hospitalizations.Clinical Trial Registration: NCT00940394: https://register.clinicaltrials.gov.

Highlights

  • Recent research in Western countries has indicated that family interventions in schizophrenia and other psychotic disorders can reduce patient relapse and improve medication compliance

  • Two hundred and one Chinese families of adult outpatients with recent-onset psychosis were randomly selected from the computerized patient lists and randomly assigned to either mutual support, psycho-education, or standard care group (n = 70 per group)

  • The results demonstrated that the family-led support group program could be a more effective community-based psychosocial intervention for Chinese psychotic patients than routine psychiatric care in improving patients’ mental state and duration of psychiatric re-hospitalizations, as well as their families’ functioning and perceived social support over 12- and 24-month follow-up

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Summary

Introduction

Recent research in Western countries has indicated that family interventions in schizophrenia and other psychotic disorders can reduce patient relapse and improve medication compliance. Psychosis is a severe mental disorder often first occurring in adolescents and young adults Disturbing psychotic symptoms such as hallucinations, delusions and disorganized thoughts, contribute to some loss of contact with reality. Intervention is based on the assumption that a stressful interpersonal environment within the family context can exacerbate psychotic symptoms and cause premature or frequent relapses. This approach to intervention is highly recommended as one of the core treatment strategies in illness management and is included in the best practice guidelines for psychosis [6, 7]

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