Systematic review and meta-analysis of family-based interventions for early psychosis: Carer and patient outcomes

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-02-01 DOI:10.1016/j.schres.2025.01.006

John F.M. Gleeson , Kelsey Ludwig , Bryan J. Stiles , Stefan Piantella , Catharine McNab , Sue Cotton , Madeleine I. Fraser , Mario Alvarez-Jimenez , Amity Watson , Elizabeth Fraser , David L. Penn

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引用次数: 0

Abstract

Background

Previous reviews have indicated that family interventions in early psychosis are beneficial for patients and family caregivers. Given recent developments in research and service provision an updated review is warranted.

Methods

We conducted a systematic review and meta-analysis of family intervention trials in the first 5 years after psychosis onset. We identified randomized controlled trials that reported outcomes for family members and extracted available outcomes in relation to identified patients.

Results

We screened 8737 abstracts and 177 full text papers, resulting in 36 for extraction. We found significant pooled treatment effects for family interventions for carer psychological distress (Hedges g = 0.35), carer burden (Hedges g = −0.68), positive and negative carer appraisals (Hedges g = 0.20, g = −0.21), and components of expressed emotion (critical comments and emotional overinvolement) compared with care as usual (Hedges g = −0.81, −0.92). For patients we found a moderate pooled effect for reduced rates of hospitalization compared with care as usual (Hedges g = −0.52). The effects for carer burden were maintained for studies in China, but not in other settings combined. The effects for hospitalization were maintained for multicomponent interventions but not when psychoeducation was the sole component. There was evidence of significant study heterogeneity. Risk of bias assessment indicated that deviations from intended treatment were most frequently rated as the weakest domain.

Conclusions

Family interventions for early psychosis benefit both family carers and their relatives diagnosed with psychosis when compared with usual care. Future research should further clarify the effective components and investigate innovations in cultural sensitivity, peer support and digital modes.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.