Intervento multifamiliare di gruppo e schizofrenia: uno studio randomizzato controllato

Objectives To assess the efficacy of a group intervention for relatives of patients with schizophrenia. To explore the feasibility of a randomized controlled trial of a psychosocial treatment in daily practice. Methods The relatives of patients with DSM-III-R schizophrenia were randomized to receive either the experimental intervention plus standard treatment or standard treatment alone. The group intervention for relatives was carried-out in the absence of patients and lasted 22 biweekly sessions. It included giving information on schizophrenia and the stress-vulnerability model, defining realistic objectives, training in communication skills, effective coping strategies, and structured problem-solving. Role playing techniques and homework assignment were widely used, with an emphasis on active learning. In each family, a key relative was asked to complete a baseline and immediately after treatment two validated instruments: the QPF on family burden and perceived support, and the QCV on the patient’s social functioning and psychological conditions. Results Initially, the two groups were similar on all outcome measures. After treatment, in the control group, we did not observe a decrease on any measure, while in the experimental group we observed a significant decrease or a statistical trend toward a decrease on all measures. We also observed a significant difference or a statistical trend toward a difference between groups on all measures. Conclusions This study suggests that randomized controlled trials are feasible also in routine practice. It supports the controversial claim that family group interventions in the absence of the patient may be effective in reducing family burden and in improving patients’ conditions, if carried out intensively and with an emphasis on active learning principles.