1.Effectiveness of family-focused intervention in patients with schizophrenia in family and community practice – A meta-analysis study
Cherry Louise M. Orfanel, MD ; Marinol B. Villafuerte, MD
The Filipino Family Physician 2023;61(1):108-116
Background:
Schizophrenia is a pervasive, chronic mental disorder that negatively impacts the biological, socioeconomic and family well being of the patient. Active involvement of family members and other significant individuals appears to benefit overall management.
Objective:
To determine the effectiveness of family-focused intervention in improving symptoms of schizophrenia.
Methods:
The authors searched for eligible clinical trials in the PubMed, Cochrane Central Register of Controlled Trials, Research Gate, Google Scholar and grey literature databases. Participants should be patients diagnosed to have schizophrenia and interventions should involve the family or be labeled as ‘family therapy.’ The primary outcome considered was symptom improvement based on the Positive and Negative Symptom Scale (PANSS). Secondary outcomes included quality of life, family functioning and subjective experience of the treatment process. The authors used the RevMan 5.4 software for data analysis. Bias, subgroup and sensitivity analyses were performed. Strength of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.
Results:
A total of 1,794 trials were initially identified, of which three publications were included in the review. Two studies used psychosocial approaches whereas one used cognitive behavioral therapy in conjunction with family intervention. Meta-analysis revealed the studies to be heterogeneous based on p values <0.10 and I2 >50%. Subgroup analysis by type of intervention showed no difference between the intervention and control groups, although there was a positive trend in favor of psychosocial intervention for improvement in PANSS score. Family-based intervention had a significant positive effect on quality of life.
Conclusion
Family-based interventions are effective in the management of schizophrenia, helping to improve quality of life, potentially reducing symptom burden and serving as an adjunct to health institution-based management.
schizophrenia
;
meta-analysis