Multiple-Family Groups and Psychoeducation in the Treatment of Schizophrenia

TLDR

The study compared outcomes of psychoeducational multiple‑family group treatment with single‑family treatment in schizophrenia. A randomized trial of 172 DSM‑III‑R schizophrenia patients aged 18–45 assigned to single‑ or multiple‑family psychoeducational groups at six New York hospitals monitored relapse, symptoms, medication adherence, rehospitalization, and employment over two years. Multiple‑family groups produced significantly lower 2‑year relapse rates (16% vs 27%) and markedly lower relapse in non‑remitted patients (13% vs 33%), with a hazard ratio of 1:3, while both modalities reduced rehospitalization and symptoms and maintained high medication compliance; overall, multiple‑family groups extended remission more effectively, especially in high‑risk patients, with a cost‑benefit ratio of up to 1:34.

Abstract

<h3>Objective:</h3> To compare outcomes in psychoeducational multiple-family group treatment vs psychoeducational single-family treatment. <h3>Method:</h3> A total of 172 acutely psychotic patients, aged 18 to 45 years, with<i>DSM-III-R</i>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. <h3>Results:</h3> 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. 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. <h3>Conclusion:</h3> 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.