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The Community Management of Schizophrenia

A Controlled Trial of a Behavioural Intervention with Families to Reduce Relapse

Published online by Cambridge University Press:  02 January 2018

Nicholas Tarrier ,
Christine Barrowclough ,
Christine Vaughn ,
J. S. Bamrah ,
Kathleen Porceddu ,
Susan Watts  and
Hugh Freeman
Nicholas Tarrier*
Affiliation:
District Department of Psychology, Prestwich Hospital, now at MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park
Christine Barrowclough
Affiliation:
District Department of Psychology, Prestwich Hospital, now at MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park
Christine Vaughn
Affiliation:
District Department of Psychology, Prestwich Hospital, now at MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park
J. S. Bamrah
Affiliation:
Hope Hospital, Salford, now Senior Registrar, Prestwich Hospital
Kathleen Porceddu
Affiliation:
Prestwich Hospital
Susan Watts
Affiliation:
University of Salford and Hope Hospital, Salford
Hugh Freeman
Affiliation:
University of Salford and Hope Hospital, Salford
*
∗District Department of Psychology, Salford Health Authority, Prestwich Hospital, Manchester M25 7BL
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Abstract

Schizophrenic patients were recruited into a trial of a prophylactic behavioural intervention with families. Families with at least one high Expressed Emotion (EE) relative were randomly allocated to one of four intervention groups: Behavioural Intervention Enactive; Behavioural Intervention Symbolic; Education Only; Routine Treatment. Patients from low-EE families were randomly allocated to two groups: Education Only or Routine Treatment. Relapse rates over nine months after discharge were significantly lower for patients in the two Behavioural Intervention, compared with Education Only and Routine Treatment groups. There was little difference between the two low-EE groups. Patients returning to high-EE relatives showed significantly higher relapse rates than those returning to low-EE relatives, in groups not receiving active intervention. Changes from high to low EE occurred in the Behavioural Intervention groups, and similar although less extensive changes occurred in the Education Only and Routine Treatment groups. Changes in criticism and marked emotional over-involvement (EOI) occurred generally in high-EE groups but were larger in magnitude in the Enactive and Symbolic groups. Reduction of hostility only occurred in the Behavioural Intervention groups. These results give partial support for the causal role of EE in relapse. There were no significant differences between the groups with respect to contact with the psychiatric services or medication.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 153 , Issue 4 , October 1988 , pp. 532 - 542
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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