[Group psychoeducational intervention in relatives of patients suffering from schizophrenia].

The present research paper aims at assessing the effectiveness of a psychoeducational intervention in relatives' groups of patients with schizophrenia or schizoaffective disorder. It examines the possible influence of the intervention on family members as well as on the course of the patient illness. Of a total of 131 relatives, 83 consisted the experimental group and 48 the control group. The relatives of the experimental group were divided into 5 groups and attended 18 psychoeducational sessions. Their patients as well s the patients and the relatives of the control group attended no specific intervention and continued their routine care. The psychoeducational intervention included education about the illness, communication skills training and training in problem-solving. It combined educational and psychotherapeutic techniques. The psychometric tools administered were: The Family Burden Scale, The Family Rituals Scale, The General Health Questionnaire GHQ-28, the Center for Epidemiological studies - Depression Scale (CES-D), the Opinions about Mental Illness Scale OMI, two scales concerning the knowledge about the illness, two questionnaires concerning expectations and feedback about the group process and questionnaires regarding sociodemographic characteristics of the sample and information about the illness. The number of hospitalizations of patients (n=91) during the research year was investigated. An interaction between group and measurement was found. While patient hospitalizations of both research groups did not differ significantly at the year before the study with X2=0.54, p=0.46), they differed when measured a year after the intervention, where patients in the intervention group had statistically significant fewer hospitalizations compared to the patients in the control group (x2=4.58, significant at p=0.032). As to the "compliance" in the medication, two statistical tests were conducted, taking into consideration that "compliance" by patients starting with a "very good" one can't be improved, while by those beginning with poor compliance can't be worsened. In the first investigation, which involved patients with possibility of amelioration or deterioration of "compliance", an improvement of patients (n=12) in the intervention group was recorded. This finding is statistically significant (p=0.0005). The second statistical test included all patients who were giving as an initial reply for the 'compliance' any value below "very good". In the intervention group there were 32 patients, 14 of whom showed improved "compliance" during the research year. This change is statistically significant (p=0.0014). The findings verify that the participation of relatives in psychoeducational groups leads to statistically significant improvement in the course of patient illness, as evident by the reduction in hospitalization rates and the improvement in adherence to pharmacotherapy. The study shows that relatives' psychoeducation constitutes a useful tool in improving the course of illness and empowering the family. The widespread implementation of relatives' psychoeducation in Greece is both necessary and challenging.

Family disruption, economic hardship and psychological distress in schizophrenia: can they be measured?

This study examined the dimensions of burden perceived by key-relatives of patients suffering from schizophrenia spectrum disorder by the development of an instrument, the Family Burden Scale (FBS) and the underlying predictors. One hundred and seventy one primary caregivers, living with 158 patients suffering from chronic psychotic illness and maintained on community basis in Athens area, were interviewed by the use of FBS supplemented by the Family Atmosphere Scale and GHQ. Construction procedure and factor analysis of FBS produced a scale of 23 items in four factors, three of them measuring objective and the fourth one, subjective burden. The scale was also proved to be reliable and valid. Forty-five percent of primary caregivers reported high levels of burden. Psychological impairment (high GHQ scores) was related with high levels of burden and negative family atmosphere. Previous admissions and duration of illness were also found to predict burden. The results suggest that FBS differentiates objective from subjective burden. Psychological well being of carers is affected by the dimensions of perceived burden.