Multiple-family groups and psychoeducation in the treatment of schizophrenia.
OBJECTIVE
To compare outcomes in psychoeducational multiple-family group treatment vs psychoeducational single-family treatment.


METHODS
A total of 172 acutely psychotic patients, aged 18 to 45 years, with DSM-III-R schizophrenic disorders were randomly assigned to single- or multiple-family psychoeducational treatment at six public hospitals in the state of New York. Psychotic relapse, symptom status, medication compliance, rehospitalization, and employment were assessed independently during 2 years of supervised treatment.


RESULTS
The multiple-family groups yielded significantly lower 2-year cumulative relapse rates than did the single-family modality (16% vs 27%) and achieved markedly lower rates in patients whose conditions had not remitted at index hospital discharge (13% vs 33%). The relapse hazard ratio between treatments was 1:3. The relapse rate for both modalities was less than half the expected rate (65% to 80% for 2 years) for patients receiving individual treatment and medication. Rehospitalization rates and psychotic symptoms decreased significantly, and medication compliance was high, to an equal degree in both modalities.


CONCLUSIONS
Psychoeducational multiple-family groups were more effective than single-family treatment in extending remission, especially in patients at higher risk for relapse, with a cost-benefit ratio of up to 1:34.
McFarlane
W R
WR
Department of Epidemiology of Mental Disorders, College of Physicians and Surgeons, Columbia University, USA.
Lukens
E
E
Link
B
B
Dushay
R
R
Deakins
S A
SA
Newmark
M
M
Dunne
E J
EJ
Horen
B
B
Toran
J
J
D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000193:education; D004651:Employment; D005196:Family Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010359:Patient Readmission; D012008:Recurrence; D012559:Schizophrenia / Q000517:prevention & control / Q000534:rehabilitation / Q000628:therapy*; D012565:Schizophrenic Psychology; D012944:Social Support; D016896:Treatment Outcome