Abstract
Long-Term Outcome of Family Therapy in Schizophrenia
Author(s): Mê Jose Masanet, Isabel Montero, Maria Lacruz, Francisco Bellver,Ildelfonso HernándezIntroduction: Cognitive-behavioral family interventions in schizophrenia have proven to be effective in reducing relapse and readmission rates, and also appear to offer other benefits to patients and their families, at least in the short-term. Of particular interest to mental health services is ascertaining how long family interventions should last to maintain their benefits over the course of time. Objective: To determine whether or not the benefits of a family intervention in schizophrenia, conducted in the clinical practice framework, are sustainable over a five-year period. Method: A follow-up over a five-year period with a representative sample of patients and their families who, five years ago, participated in a twelve-month long, cognitivebehavioral family intervention. Results: 53.5% of patients had at least one relapse, and 16.9% followed a continuous course. The number of positive symptoms was higher after follow-up than at the end of the intervention, with significant worsening in delusions (Wilcoxon, Z=-1.959, p=0.050) and thought disorder (Wilcoxon, Z=-2.767, p=0.006); whereas social adjustment was maintained stable over time. Psychological distress in the key family member decreased significantly over time (p=0.050), and family expressed emotion remained at levels similar to those at the end of the intervention. Conclusion: Even if there is some loss of benefits from post-test to follow-up, the intervention could have overall net benefits. Subsequent studies should develop cost-efficient strategies for maintaining those patients who show excellent short-term clinical and social recovery.