Effects on family functioning and the home environment of a family-based preventive intervention for children of parents with severe mental illness: A randomized controlled trial.
Ida Christine Tholstrup Gjøde, Anne Dorothee Müller, Carsten Hjorthøj, Nicoline Hemager, Sidsel Ingversen, Mala Moszkowicz, Sofie Heidenheim Christensen, Lisbeth Juhl Mikkelsen, Signe Sofie Nielsen, Marianne Melau, Julie Forman, Merete Nordentoft, Anne Amalie Elgaard Thorup
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引用次数: 0
Abstract
Objective: Children of parents with severe mental illness are at increased risk of mental illness throughout their lifespan due to complex gene-environment interactions. Preventive interventions supporting parents and children are warranted. Compared with usual treatment, we tested the effectiveness of a multidisciplinary family-based preventive intervention, VIA Family.
Method: We did a parallel randomized controlled superiority trial in Copenhagen, Denmark. A total of 95 families, of 95 parents with either schizophrenia spectrum disorder (n = 12 [12.6%]), bipolar disorder (n = 25 [26.3%]), or recurrent major depressive disorder (n = 58 [61.1%]), participated. A total of 179 coparents and 113 children (6-12 years) participated. Assessments took place at baseline and after 18 months of intervention. We estimated the effects on family functioning with the McMaster Family Assessment Device and on levels of stimulation and support in the home environment with the Home Observation Measurement of the Environment.
Results: Effects on family functioning did not differ between the two groups: parents with severe mental illness (0.11; 95% CI [-0.10, 0.31]), p = .296, and coparents (-0.07; 95% CI [-0.27, 0.13]), p = .482. Assessor-rated levels of stimulation and support in the home environment improved in VIA Family, but not significantly compared with usual treatment (Mdiff: 1.79; 95% CI [-0.37, 3.95], p = .104). Sensitivity analyses confirmed our main findings.
Conclusions: Effects on family functioning and the home environment did not differ between VIA Family and usual treatment. We cannot rule out a clinically relevant effect of VIA Family on levels of stimulation and support in the home environment. Long-term follow-up will investigate potential preventive effects. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的：由于复杂的基因-环境相互作用，父母患有严重精神疾病的儿童在其一生中患精神疾病的风险增加。支持父母和儿童的预防性干预措施是必要的。与常规治疗相比，我们测试了多学科家庭预防干预的有效性，VIA家庭。方法：在丹麦哥本哈根进行平行随机对照优势试验。共有95个家庭，95名父母患有精神分裂症谱系障碍（n = 12[12.6%]）、双相情感障碍（n = 25[26.3%]）或复发性重度抑郁症（n = 58[61.1%]）。共有179名家长和113名儿童（6-12岁）参与。评估分别在基线和干预18个月后进行。我们用麦克马斯特家庭评估装置评估了对家庭功能的影响，用家庭环境观察测量法评估了家庭环境中的刺激和支持水平。结果：两组对家庭功能的影响无显著差异：父母有严重精神疾病(0.11；95% CI [-0.10, 0.31]), p = .296，父母(-0.07；95% CI [-0.27, 0.13]), p = .482。在VIA家庭中，评估者评定的家庭环境中的刺激和支持水平有所改善，但与常规治疗相比并不显著(Mdiff: 1.79；95% CI [-0.37, 3.95], p = 0.104)。敏感性分析证实了我们的主要发现。结论：VIA家庭治疗与常规治疗对家庭功能和家庭环境的影响无显著差异。我们不能排除VIA家庭对家庭环境中刺激和支持水平的临床相关影响。长期随访将调查潜在的预防效果。（PsycInfo Database Record (c) 2024 APA，版权所有）。
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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