An exploratory randomised controlled trial of a support programme for carers of patients with a psychosis.
BACKGROUND
Despite an acknowledgement of the impact of serious mental disorders on informal caregivers, we still know little about how to best help them. The aim of the study was to evaluate the effectiveness of a two-phased carers' intervention comprising family sessions followed by relatives' groups. This intervention was designed to be of 'intermediate' intensity, that is,one lying between brief educational programmes and long-term family psychoeducational treatments.


METHODS
An exploratory randomised controlled trial was conducted comparing the experimental support programme with 'standard' care. All carers of patients with a psychotic disorder from a defined population were approached. Outcome measures were based on a 'stress-appraisal-coping' model of caregiving.


RESULTS
Despite concerted attempts to engage carers, only 42% participated in the study. The carers' programme did not offer any significant advantage on any of the outcome measures: psychological morbidity, negative appraisal, coping or social support. The severity of caregiving difficulties decreased over the study period for the group as a whole.


CONCLUSIONS
There is still uncertainty about the most effective interventions for carers. Meeting 'needs' may not improve caregiver distress.
Szmukler
G
G
Health Services Research Dept., Institute of Psychiatry, Kings College London & South London and Maudsley NHS Trust, London, UK.
Kuipers
E
E
Joyce
J
J
Harris
T
T
Leese
M
M
Maphosa
W
W
Staples
E
E
D000223:Adaptation, Psychological; D017028:Caregivers; D017281:Cost of Illness; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000628:therapy*; D012944:Social Support; D011795:Surveys and Questionnaires