Family Intervention may Prevent Relapse of Schizophrenia

by Dr. Nithin Jayan on  January 17, 2011 at 7:08 PM Health Watch   - G J E 4
Family intervention for people with schizophrenia may decrease the risk of relapse. It may also help people with schizophrenia to consistently take their medication. Schizophrenia is a chronic, relapsing mental illness. It has a worldwide lifetime prevalence of about 1%, irrespective of culture, social class and race. The disease is characterised by positive symptoms and negative symptoms. Positive symptoms include hallucinations and delusions while negative ones include emotional numbness and withdrawal. Available medications are effective in reducing positive symptoms. Negative symptoms are, unfortunately immune to treatment. Drug treatments are also associated with adverse effects.

Half of the patients have a recurrent illness. Recurrence often follows long episodes of considerable recovery from the positive symptoms. Prevention of relapse is a cornerstone of psychiatric care. An influential study in 1972 showed that patients from families that tend to be less expressive of their emotions had fewer relapses. Thus walked in, the requirement to address the ones from families that express high levels of criticism, hostility, or over involvement since they were found to be more prone to frequent relapses. Psychosocial interventions were designed to reduce these levels of expressed emotions within families.

Psychosocial interventions would serve as adjuncts rather than alternatives to drug treatments. The effects of family psychosocial interventions in people with schizophrenia were assessed in a recent study. The results were published in Cochrane Database of Systematic Reviews.

The strategies of intervention included:

• Reduction of adverse family atmosphere (that is, lowering the emotional climate in the family by reducing stress and burden on relatives)

• Enhancement of the capacity of relatives to anticipate and solve problems

• Construction of an alliance with relatives who care for the person with schizophrenia

• Reduction of expressions of anger and guilt by the family

• Maintenance of reasonable expectations for patient performance

• Encouragement of relatives to set and keep to appropriate limits whilst maintaining some degree of separation when needed 

• Attainment of desirable change in relatives' behaviour and belief systems.

The analysis suggests that family intervention may decrease the risk of relapse and may also help people with schizophrenia to consistently take their medication. A reduced level of expressed emotion, stress, family burden, and enhanced capacity of relatives to solve problems aid patients. Family intervention can also make family life less burden some and tense and may reduce re-hospitalisation. High quality family service aids clinicians in better management of the psychiatric disorder. Prevention of relapse is of profound value in psychiatric care.

Source: Cochrane Database of Systematic Reviews2006, Issue 4.

Article: Family intervention for schizophrenia: Pharoah F, Mari J, Rathbone J, Wong W.

Source: Medindia

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