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A randomized trial to assess the efficacy of a psychoeducational intervention on caregiver burden in schizophrenia

Published online by Cambridge University Press:  23 March 2020

M. Martín-Carrasco ,
P. Fernández-Catalina ,
A.I. Domínguez-Panchón ,
M. Gonçalves-Pereira ,
E. González-Fraile ,
P. Muñoz-Hermoso ,
J. Ballesteros  and
the EDUCA-III group
M. Martín-Carrasco
Affiliation:
Institute of Psychiatric Research, Bilbao, Spain Padre Menni Psychiatric Centre, Pamplona, Spain CIBER Mental HealthSpain
P. Fernández-Catalina
Affiliation:
Psychosocial Rehabilitation Resource (Sisters Hospitallers), Madrid, Spain
A.I. Domínguez-Panchón
Affiliation:
Aita-Menni Hospital, Arrasate-Mondragón, Spain
M. Gonçalves-Pereira
Affiliation:
Clínica Psiquiátrica de S. José (Sisters Hospitallers), Lisboa, Portugal CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
E. González-Fraile*
Affiliation:
Institute of Psychiatric Research, Bilbao, Spain
P. Muñoz-Hermoso
Affiliation:
Padre Menni Psychiatric Centre, Pamplona, Spain
J. Ballesteros
Affiliation:
University of the Basque Country, UPV/EHU, Leioa, Spain CIBER Mental HealthSpain
*
⁎ Corresponding author. Instituto de Investigaciones Psiquiá tricas, C/Eganã 10, 48010 Bilbao, Spain. Tel.: +34 94 443 4927; fax: +34 94 443 7131. E-mail address:iip@fundacion-iip.org (E. Gonzaález-Fraile).
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Abstract

Background

Patient's relatives usually care for patients with schizophrenia, and as informal caregivers they experience negative consequences. The aim of the EDUCA-III trial is to test the efficacy of a psychoeducational intervention program (PIP) versus standard care to reduce the caregiver burden at post-intervention (4 months), and at follow-up (8 months).

Method

A two-arm, evaluator blind, multicentre, randomized controlled trial. The PIP group had 12 weekly group sessions. The control intervention group had the usual support and standard care. Primary outcomes were change scores since baseline on the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ).

Results

One hundred and nine caregivers were randomized to PIP and 114 to control condition from 23 research sites. The decrease of ZBI scores was significantly higher on the PIP arm at 4 months (mean difference [MD] = −4.33; 95% CI −7.96, −0.71), and at 8 months (MD = −4.46; 95% CI −7.79, −1.13). There were no significant decreases in the IEQ scores (MD at 4 months = −2.80; 95% CI −6.27, 0.67; MD at 8 months = −2.85; 95% CI −6.51, 0.81).

Conclusions

The PIP condition seems to reduce caregiver burden.

Trial registration

ISRCTN32545295.

Keywords

SchizophreniaCaregiversMental healthRandomized controlled trial
Type
Original article
Information
European Psychiatry , Volume 33 , Issue 1 , March 2016 , pp. 9 - 17
Copyright
Copyright © European Psychiatric Association 2016

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References

Whiteford, H.A.Degenhardt, L.Rehm, J.Baxter, A.J.Ferrari, A.J.Erskine, H.E., et al.Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010 Lancet 2013; 382(9904): 1576–1586CrossRefGoogle ScholarPubMed
Thornicroft, G.Tansella, M.The balanced care model: the case for both hospital- and community-based mental healthcare. Br J Psychiatry 2013; 202(4): 246–248CrossRefGoogle ScholarPubMed
Magliano, L.Fadden, G.Madianos, M.de Almeida, J.M.Held, T.Guarneri, M., et al.Burden on the families of patients with schizophrenia: results of the BIOMED I study Soc Psychiatry Psychiatr Epidemiol 1998; 33(9): 405–412CrossRefGoogle ScholarPubMed
Awad, A.G.Voruganti, L.The burden of schizophrenia on caregivers: a review. Pharmacoeconomics 2008; 26: 149–162CrossRefGoogle ScholarPubMed
Zarit, S.H.Reever, K.E.Bach-Peterson, J.Relatives of the impaired elderly: correlates and feelings of burden. Gerontologist 1980; 20: 649–655CrossRefGoogle ScholarPubMed
Grad, J.Sainsbury, P.Mental illness and the family. Lancet 1963; 9(1): 544–547CrossRefGoogle Scholar
Szmukler, G.From family “burden” to caregiving. Psychiatr Bull 1996; 20: 449–451CrossRefGoogle Scholar
Perlick, D.A.Ra, R.Kaczynski, R.Swartz, M.S.Canive, J.M.Lieberman, J.A.Components and correlates of family burden in schizophrenia. Psychiatr Serv 2006; 57: 1117–1125CrossRefGoogle Scholar
van Wijngaarden, B.Schene, A.H.Koeter, M.Becker, T.Knapp, M.Knudsen, H.C., et al.People with schizophrenia in five countries: conceptual similarities and intercultural differences in family caregiving Schizophr Bull 2003; 29: 573–586CrossRefGoogle ScholarPubMed
Magliano, L.Fiorillo, A.Fadden, G.Gair, F.Economou, M.Kallert, T., et al.Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: preliminary results of a study funded by the European Commission World Psychiatry 2005; 4(1): 45–49Google ScholarPubMed
Sin, J.Norman, I.Psychoeducational interventions for family members of people with schizophrenia: a mixed-method systematic review. J Clin Psychiatry 2013; 74(12): 1145–1162CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence Schizophrenia: Core interventions in the treatment and management of schizophrenia in primary and secondary care (update version) 2010 National Collaborating Centre for Mental Health LondonGoogle Scholar
Baüml, J.Froböse, T.Kraemer, S.Rentrop, M.Pitschel-Walz, G.Psychoeducation:, a basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophr Bull 2006; 32(Suppl. 1):S1–S9CrossRefGoogle ScholarPubMed
Wisniewski, S.R.Belle, S.H.Coon, D.W., et al.The Resources for Enhancing Alzheimer's Caregiver Health (REACH): project design and baseline characteristics Psychol Aging 2003; 18: 375–384CrossRefGoogle ScholarPubMed
van Wijngaarden, B.Schene, A.H.Koeter, M.Vázquez-Barquero, J.L.Knudsen, H.C.Lasalvia, A., et al.Caregiving in schizophrenia: development, internal consistency and reliability of the Involvement Evaluation Questionnaire - European version: EPSILON study 4 Br J PsychiatrSuppl. 392000 s21–s27CrossRefGoogle ScholarPubMed
Gonçalves-Pereira, M.Zarit, S.H.The Zarit Burden Interview in Portugal: validity and recommendations in dementia and palliative care. Acta Med Port 2014; 27(2): 163–165CrossRefGoogle ScholarPubMed
Chien, W.T.Lee, Y.M.A disease management program for families of persons in Hong Kong with dementia. Psychiatr Serv 2008; 59(4): 433–436CrossRefGoogle Scholar
Navidian, A.Kermansaravi, F.Rigi, S.N.The effectiveness of a group psycho-educational program on family caregiver burden of patients with mental disorders. BMC Research Notes 2012; 5(399)CrossRefGoogle ScholarPubMed
Tanrıverdi, D.Ekinci, M.The effect psychoeducation intervention has on the caregiving burden of caregivers for schizophrenic patients in Turkey. Int J Nurs Pract 2012; 18(3): 281–288CrossRefGoogle ScholarPubMed
Martin-Carrasco, M.Otermin, P.Pérez-Camo, V.Pujol, J.Agüera, L.Martín, M.J., et al.EDUCA study: psychometric properties of the Spanish version of the Zarit Caregiver Burden Scale Aging Ment Health 2010; 14(6): 705–711CrossRefGoogle ScholarPubMed
Gonçalves-Pereira, M.Carmo, I.Da-Silva, J.A.Papoila, A.L.Mateos, R.Zarit, S.H.Caregiving experiences and knowledge about dementia in Portuguese clinical outpatient settings. Int Psychogeriatr 2010; 22: 277–280CrossRefGoogle ScholarPubMed
Schene, A.H.van Wijngaarden, B.Koeter, M.W.Family caregiving in schizophrenia: domains and distress. Schizophr Bull 1998; 24: 609–618CrossRefGoogle ScholarPubMed
Gonçalves-Pereira, M.van Wijngaarden, B.Xavier, M.Papoila, A.L.Caldas-de-Almeida, J.M.Schene, A.H.Caregiving in severe mental illness: the psychometric properties of the Involvement Evaluation Questionnaire in Portugal. Ann Gen Psychiatry 2012; 11:810.1186/1744-859X-11-8CrossRefGoogle ScholarPubMed
Goldberg, D.P.Hillier, V.F.A scaled version of the General Health Questionnaire. Psychol Med 1979; 9: 139–145CrossRefGoogle ScholarPubMed
Radloff, L.S.The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure 1977; 1: 385–401CrossRefGoogle Scholar
Lobo, A.Pérez-Echeverría, M.J.Artal, J.Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychol Med 1986; 16: 135–140CrossRefGoogle Scholar
Pais-Ribeiro, J.L.Antunes, S.Contribution to the study of adaptation of the 28 items General Health Questionnaire (GHQ 28) into Portuguese. Revista Portuguesa de Psicossomatica 2003; 5: 37–45Google Scholar
Pérez-Sola, J.S.Puigdemont, V.Pérez-Blanco, D.Figueres, J.Alvarez, M.E.Estudio de validación del Center for Epidemiologic Studies-Depression (CES-D) en trastornos afectivos en población Española. Actas Luso Esp Neurol Psiquiatr Cien Afin 1997; 25: 243–249Google Scholar
Gonçalves, B.Fagulha, T.The Portuguese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Eur J Psychol Assess 2004; 20: 339–348CrossRefGoogle Scholar
Blockrand: randomization for block random clinical trials [Internet]. CRAN. Rproject.org 2013 [http://CRAN.Rproject.org/package=blockrand, cited 2013 Mar 25]Google Scholar
Cohen, J.Statistical Power Analysis for the Behavioral Sciences 2nd ed. 1988 Erlbaum Hillsdale, NJGoogle Scholar
Pinheiro, J.C.Bates, D.M.Mixed-effects models in S and S-PLUS New York: Springer; 2004Google Scholar
Vella, S.-L.Pai, N.The measurement of burden of care in serious mental illness: a qualitative review. Aust N Z J Psychiatry 2012; 47(3): 222–234CrossRefGoogle ScholarPubMed
Chien, W.-T.Chan, S.Thompson, D.R.Effects of a mutual support group for families of Chinese people with schizophrenia: 18-month follow-up. Br J Psychiatry 2006; 189: 41–49CrossRefGoogle ScholarPubMed
Magliano, L.Fiorillo, A.Malangone, C.De Rosa, C.Maj, M.Patient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatr Serv 2006; 57: 1784–1791CrossRefGoogle Scholar
Chien, W.-T.Wong, K.-F.A family psychoeducation group program for Chinese people with schizophrenia in Hong Kong. Psychiatr Serv 2007; 58: 1003–1006CrossRefGoogle ScholarPubMed
Koolaee, A.K.Etemadi, A.The outcome of family interventions for the mothers of schizophrenia patients in Iran. Int J Soc Psychiatr 2010; 56: 634–646CrossRefGoogle ScholarPubMed
Sharif, F.Shaygan, M.Mani, A.Effect of a psycho-educational intervention for family members on caregiver burdens and psychiatric symptoms in patients with schizophrenia in Shiraz, Iran. BMC Psychiatry 2012; 12(48):CrossRefGoogle ScholarPubMed
Yesufu-Udechuku, A.Harrison, B.Mayo-Wilson, E.Young, N.Woodhams, P.Shiers, D., et al.Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry 2015; 206(4): 268–274CrossRefGoogle ScholarPubMed
Kuipers, EYesufu-Udechuku, ATaylor, CKendall, T.Management of psychosis and schizophrenia in adults: summary of updated NICE guidance. Br Med J 348:g1173. doi:10.1016/10.1136/bmj.g1173.CrossRefGoogle Scholar
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