Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study.

BACKGROUND: Empirical evidence of the efficacy and effectiveness of psychosocial family intervention and of the specificity of its effects on the course of schizophrenia is limited. The aim was to study the efficacy and effectiveness of psychosocial family intervention with regard to clinical and social functioning and family burden after controlling for compliance and several prognostic factors. METHOD: A 2-year randomized controlled trial with blind assessments. Fifty patients with DSM-IV schizophrenia and persistent positive symptoms and/or previous clinical relapse were allocated to psychosocial family intervention, individual counselling and standard treatment versus individual counselling and standard treatment. RESULTS: Family intervention was associated with fewer clinical relapses, hospitalizations and major incidents, and an improvement in positive and negative symptoms, social role performance, social relations, employment and family burden. The reduction in hospitalizations in the family intervention group was significantly greater than that observed in the group of patients who refused to participate but this was not the case for the control group. The effects of family intervention were independent of compliance and prognostic factors. CONCLUSIONS: Family intervention is effective in severe schizophrenia independently of compliance and prognostic factors.

[Acceptability, reliability and validity of the Corney and Clare social problems questionnaire]. / Aceptabilidad, fiabilidad y validez del cuestionario de problemas sociales de Corney y Clare.

OBJECTIVE: To evaluate the acceptability, reliability and concurrent validity of the CORNEY and CLARE self-administered social problems questionnaire. DESIGN: Reliability was studied by a test-retest (24 hours). Validity (concordance) was studied through comparison with a standard social adaptation interview. SETTING: Primary Health Care. PATIENTS: Consecutive patients attached to a long-treatment nursing station and 4 medical clinics. MEASUREMENTS AND MAIN RESULTS: The questionnaire consisted of 33 items and evaluated 9 areas of social functioning. In each area, the items covered 2 types of evaluation: problems in objective circumstances or in functioning and level of satisfaction. There were no significant difficulties in the questionnaire's administration. In the test-retest evaluation, there was adequate concordance of the average scores of the items evaluating difficulties and problems. This was not the case for the average scores of the items which evaluated satisfaction. The validity of 28 of the questionnaire's 33 items was examined. A moderate concordance level was found for 11 items on the questionnaire. An average score taken from these items provided a sufficient measurement of tendency regarding the overall seriousness of the subjects' social problems. CONCLUSIONS: The results do not favour the use of this questionnaire as a substitute for standard interviews in the evaluation of specific social problems, but do support the use of part of it in order to obtain a valid tendency measurement.