Evaluation of Family Psychoeducation Efficacy in Schizophrenia: A Way to Do it More Simply for Routinely Monitoring

Abstract

Background: Despite many control trials and meta-analyses proving the positive effect and the economic interest of family psychoeducation in schizophrenia, this practice remains marginal. There may be several reasons behind the clinicians' lack of motivation to implement such programs. Simple and common evaluation tools to compare program efficacy, improve the programs' content, and guaranty the fidelity of the delivery over time by routinely monitoring the efficacy level would be a way (among many) to stimulate clinical interest in psychoeducation. Two common self-administered questionnaires used in combination, the Center for Epidemiologic Studies Depression (CESd) to assess caregivers' depressive symptoms and 20-item Life Skill Profile (LSP-20) to assess patient functioning, would be good candidates for that. Methods: Family caregivers (n = 78) of seven consecutive groups participating in a program named Profamille filled in these questionnaires before and at the end of the program and 1 year later. More than the half of the caregivers have an initial depressive score indicating a higher risk of cardiovascular mortality/morbidity. Results: Both CESd and LSP20 significantly changed 1 year later. The size effect for CESd was 1.4 and for LSP20 was 0.6. These changes were linked to a statistically significant reduction in the number of hospitalized days for the patients (by a factor 3) and a number of days lost at work for the caregivers (by a factor 4). Conclusions: These two questionnaires are therefore useful to compare different programs, obtain preliminary evidence from exploratory trials, like for the Profamille V3 program, and help ensure the fidelity of program delivery.