Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One-year effects of a controlled study on relapse and expressed emotion.
Relapse rates averaging 41% in the first year after discharge among schizophrenic patients receiving maintenance neuroleptic treatment led to the development of two disorder-relevant treatments: a patient-centered behavioral treatment and a psychoeducational family treatment. Following hospital admission, 103 patients residing in high expressed emotion (EE) households who met Research Diagnostic Criteria for schizophrenia or schizoaffective disorder were randomly assigned to a two-year aftercare study of family treatment and medication, social skills training and medication, their combination, or a drug-treated condition. First-year relapse rates among those exposed to treatment demonstrate a main effect for family treatment (19%), a main effect for social skills training (20%), and an additive effect for the combined conditions (0%) relative to controls (41%). Effects are explained, in part, by the absence of relapse in any household that changed from high to low EE. Only the combination of treatment sustains a remission in households that remain high in EE. Continuing study, however, suggests a delay of relapse rather than prevention.
Hogarty
G E
GE
Anderson
C M
CM
Reiss
D J
DJ
Kornblith
S J
SJ
Greenwald
D P
DP
Javna
C D
CD
Madonia
M J
MJ
D000328:Adult; D000359:Aftercare; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D001521:Behavior Therapy; D002986:Clinical Trials as Topic; D004644:Emotions; D005190:Family; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D012008:Recurrence; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D012565:Schizophrenic Psychology; D012917:Social Adjustment
D014150:Antipsychotic Agents