Family Intervention in First-Episode Psychosis

Anvar Sadath,Shivarama Varambally,B N Gangadhar,Justin P Jose,D Muralidhar

doi:10.1177/2158244015613108

Abstract

Family interventions have produced benefits on clinical and family outcomes in long standing psychosis. However, little is known about the efficacy of such interventions in the early stages of psychosis. This article reviews published research over the last two decades on family intervention in first-episode psychosis. Electronic databases, such as PubMed, PsycINFO, and ScienceDirect, have been systematically searched. In addition, an exhaustive Internet search was also carried out using Google and Google Scholar to identify the potential studies that evaluated family interventions in first-episode psychosis. We have identified seven reports of five randomized controlled trials (RCTs) and five non-randomized and uncontrolled studies of family intervention. Our review on 12 reports of family intervention studies has shown mixed effects on outcomes in first-episode psychosis. Most of the reports showed no added benefits or very short-term benefits on primary clinical or family outcome variables. There is a dearth of family intervention studies in first-episode psychosis. More RCTs are needed to reach reliable conclusions.

Highlights

The role of families in treatment of psychiatric patients has become increasingly important, mainly due to two reasons
Literature shows that providing care to a person with severe mental illness can adversely affect the mental health and well-being of family caregivers (Hayes, Hawthorne, Farhall, O’Hanlon, & Harvey, 2015; Hernandez & Barrio, 2015)
Family interventions are strongly recommended in many standard clinical practice guidelines for the treatment of schizophrenia (Kreyenbuhl, Buchanan, Dickerson, & Dixon, 2010) and early psychosis (International Early Psychosis Association Writing Group, 2005)

Summary

Introduction

The role of families in treatment of psychiatric patients has become increasingly important, mainly due to two reasons. Some factors in family members’ behavior and attitude to patients such as criticality, hostility, and over-involvement, known as expressed emotion (EE), significantly predict relapse in individuals with prolonged psychosis (Barrowclough & Hooley, 2003; Pharoah, Mari, Rathbone, & Wong, 2010; Roseliza-Murni, Oei, Fatimah, & Asmawati, 2014) and firstepisode psychosis (King & Dixon, 1999). Family interventions are strongly recommended in many standard clinical practice guidelines for the treatment of schizophrenia (Kreyenbuhl, Buchanan, Dickerson, & Dixon, 2010) and early psychosis (International Early Psychosis Association Writing Group, 2005)

Results

Discussion

Conclusion