Salud Mental

Effectiveness of behavioral family therapy in people with schizophrenia: a randomized, controlled clinical trial

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Daisy Angélica Vidal Gutiérrez
Sandra Saldivia
Pamela Grandón Fernández
Carolina Inostroza Rovegno

Abstract

Objective. To evaluate the effectiveness of FBT in comparison with usual care in people with schizophrenia treated at an outpatient psychiatric department of a public hospital in Chile.

Method. Quantitative study, with a randomized, controlled clinical trial design (CTCT) and pre-post measurements, with two arms. Fifty-four people with schizophrenia and their primary caregivers, randomly assigned to experimental and control groups, were studied. The main outcome variable was social functioning. As secondary outcomes, clinical symptoms and treatment adherence in people with schizophrenia were evaluated. Expressed emotion was evaluated in the primary caregiver.

Results. FBT was effective in improving the social functioning of people with schizophrenia and decreasing expressed emotion in the primary caregiver, with a large effect size (d > 0.80).

Conclusions. The implementation of FBT as a protocolized intervention, complementing usual care, helps to improve psychosocial outcomes in people with schizophrenia and their caregivers.
Keywords:
Effectiveness, schizophrenia, expressed emotion, social functioning, family therapy

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References

Amaresha, A. C., & Venkatasubramanian, G. (2012). Expressed emotion in schizophrenia: an overview. Indian journal of psychological medicine, 34(1), 12.

Bebbington, P., Kuipers, L., & Ballenger, J. C. (1996). the Predictive Utility of Expressed Emotion in Schizophrenia: An Aggregate Analysis. Year Book of Psychiatry & Applied Mental Health, 1996(8), 349-350.

Brown, G. W. (1959). Experiences of discharged chronic schizophrenic patients in various types of living group. The Milbank Memorial Fund Quarterly, 37(2), 105-131.

Brown, G. W. and Rutter, M. L. (1966). “The measurement of family activities and relationships.” Human Relations, 19, 241.

Brown, G. W., & Rutter', M. (1966). The measurement of family activities and relationships: A methodological study. Human relations, 19(3), 241-263.

Brown, G. W., Birley, J. L. T., and Wing, J. K. (1972) Influence of Family Life on the Course of Schizophrenic Disorders: A Replication. British Journal of Psychiatry 121: 241-58.

Bucci, S., Berry, K., Barrowclough, C., & Haddock, G. (2016). Family interventions in psychosis: a review of the evidence and barriers to implementation. Australian Psychologist, 51(1), 62-68.

Burbach, F. R., Fadden, G., & Smith, J. (2010). Family Interventions for First‐Episode Psychosis. Promoting Recovery in Early Psychosis: A Practice Manual, 210-225.

Caqueo-Urízar, A., Rus-Calafell, M., Urzúa, A., Escudero, J., & Gutiérrez-Maldonado, J. (2015). The role of family therapy in the management of schizophrenia: challenges and solutions. Neuropsychiatric disease and treatment, 11, 145.

Cirici, R. (2002). La adherencia al tratamiento de los pacientes psicóticos. Rev Psiquiatría Fac Med Barna, 29(4), 232-238.

Cohen, J. (1992). Quantitative methods in psychology: A power primer. Psychol. Bull., 112, 1155-1159.

Espina, A., & González, P. (2003). Intervenciones familiares en la esquizofrenia. Cambios en la sintomatología y el ajuste social. Salud Mental, 26(1), 51-58.

Falloon, I. R. H., & Liberman, R. P. (1983). Behavioral family interventions in the management of chronic schizophrenia. Family therapy in schizophrenia, 117-137.

Garcia-Portilla, M. P., Saiz, P. A., Bousoño, M., Bascaran, M. T., Guzmán-Quilo, C., & Bobes, J. (2011). Validation of the Spanish Personal and Social Performance scale (PSP) in outpatients with stable and unstable schizophrenia. Revista de Psiquiatría y Salud Mental (English Edition), 4(1), 9-18.

Gonçalves-Pereira, M., Xavier, M., & Fadden, G. (2007). O Modelo de Falloon para intervenção familiar na esquizofrenia: Fundamentação e aspectos técnicos. Análise psicológica, 25(2), 241-255.

Grácio, J., Gonçalves‐Pereira, M., & Leff, J. (2016). What do we know about family interventions for psychosis at the process level? A systematic review. Family process, 55(1), 79-90.

Kavanagh, D. J. (1992). Recent developments in expressed emotion and schizophrenia. The British Journal of Psychiatry, 160(5), 601-620.

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia bulletin, 13(2), 261-276.

Leff, J., Kuipers, L., Berkowitz, R., Eberlein-Vries, R., & Sturgeon, D. (1982). A controlled trial of social intervention in the families of schizophrenic patients. The British Journal of Psychiatry, 141(2), 121-134.

Lobban, F., & Barrowclough, C. (2016). An interpersonal CBT framework for involving relatives in interventions for psychosis: evidence base and clinical implications. Cognitive therapy and research, 40(2), 198-215.

Lobban, F., Postlethwaite, A., Glentworth, D., Pinfold, V., Wainwright, L., Dunn, G., ... & Haddock, G. (2013). A systematic review of randomised controlled trials of interventions reporting outcomes for relatives of people with psychosis. Clinical Psychology Review, 33(3), 372-382.

Magaña, A. B., Goldstein, M. J., Karno, M., Miklowitz, D. J., Jenkins, J., & Falloon, I. R. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry research, 17(3), 203-212.

Marvin, S. E., Miklowitz, D. J., O'brien, M. P., & Cannon, T. D. (2016). Family‐focused therapy for individuals at clinical high risk for psychosis: treatment fidelity within a multisite randomized trial. Early intervention in psychiatry, 10(2), 137-143.

McFarlane, W. R. (2016). Family interventions for schizophrenia and the psychoses: A review. Family Process, 55(3), 460-482.

Ministerio de Salud, Chile. (2005). Guía clínica: primer episodio esquizofrenia.

Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical care, 67-74.

Nilsen, L., Frich, J. C., Friis, S., Norheim, I., & Røssberg, J. I. (2016). Participants' perceived benefits of family intervention following a first episode of psychosis: a qualitative study. Early intervention in psychiatry, 10(2), 152-159.

Olivares, E. B., Arango, C., & Buchanan, R. W. (2000). El Eje Hipotalámico-Hipofisiario-Adrenal (HPA) y Regulación del Cortisol Plasmático en la Esquizofrenia.

Peralta Martín, V., & Cuesta Zorita, M. J. (1994). Validacion de la escala de los sindromes positivo y negativo (IPANSS) en una muestra de esquizofrenicos espanoles. Actas Luso Espanolas de Neurologia Psiquiatria y Ciencias Afines, 22(4), 171-177.

Pharoah, F., Mari, J., Rathbone, J., & Wong, W. (2010). Family intervention for schizophrenia. The Cochrane database of systematic reviews, (12), CD000088.

Richardson, H. B. (1945). Patients have families.

Roncone, R., Morosini, P., Falloon, I. R., & Casacchia, M. (2002). Family interventions in schizophrenia in Italian mental health services. In Comprehensive treatment of schizophrenia (pp. 284-289). Springer, Tokyo.

Saiz Ruiz, J., Sánchez, V., Diego, C., & Sánchez Páez, P. (2010). Bases neurobiológicas de la Esquizofrenia. Clínica y salud, 21(3), 235-254.

Vaughn, C. E. (1986). Patterns of emotional response in the families of schizophrenic patients. In Treatment of schizophrenia (pp. 97-106). Springer, Berlin, Heidelberg.

Zubin, J., & Spring, B. (1977). Vulnerability: A new view of schizophrenia. Journal of Abnormal Psychology, 86(2), 103-126.