Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T18:14:43.067Z Has data issue: false hasContentIssue false

A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients

Published online by Cambridge University Press:  29 January 2018

Julian Leff
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London SE5
Rosemarie Eberlein-Vries
Affiliation:
Psychiatrische Universitaetsklinik, Nussbaumstrasse, D8 Munich 2
David Sturgeon
Affiliation:
Department of Mental Health, School of Medicine, University College, London WC1

Summary

A study is reported of a controlled trial of social intervention in the families of schizophrenic patients at high risk of relapse. The patients were selected for being in high contact with high Expressed Emotion relatives. All patients were maintained on neuroleptic drugs. One half of the 24 families were randomly assigned to routine out-patient care, while the other half received a package of social interventions. This comprised a programme of education about schizophrenia, a group for the relatives, and family sessions for relatives and patients.

The relapse rate in the control group was 50 per cent compared with nine per cent in the experimental group (P = 0.04). The stated aims of the therapeutic interventions were achieved in 73 per cent of experimental families. In these families, no patient relapsed. The results provide evidence for the causal role of relatives' expressed emotion (EE) in schizophrenic relapse, as well as for the therapeutic effectiveness of social intervention combined with drug treatment.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1982 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berkowitz, R., Kuipers, L., Eberlein-Fries, R. & Leff, J. (1981) Lowering expressed emotion in relatives of schizophrenics. In New Developments in Interventions with Families of Schizophrenics, (ed. Goldstein, M. S.). London: Jossey-Bass Google Scholar
Brown, G. W. & Birley, J. L. T. (1968) Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behaviour, 9, 203–14.CrossRefGoogle ScholarPubMed
Brown, G. W. Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–58.CrossRefGoogle ScholarPubMed
Brown, G. W. Monck, E. M., Carstairs, G. M. & Wing, J. K. (1962) Influence of family life on the course of schizophrenic illness. British Journal of Preventive and Social Medicine, 16, 5568.Google Scholar
Creer, C. & Wing, J. (1975) Living with a schizophrenic patient. British Journal of Hospital Medicine, 14, 7382.Google Scholar
Goldstein, M. J., Rodnick, E. H., Evans, J. R., May, P. R. A. & Steinberg, M. R. (1978) Drug and family therapy in the aftercare of acute schizophrenics. Archives of General Psychiatry, 35, 1169–77.CrossRefGoogle ScholarPubMed
Hirsch, S. R. & Leff, J. P. (1975) Abnormalities in Parents of Schizophrenics. Maudsley Monograph No 22. London: Oxford University Press Google Scholar
Hogarty, G. E. & Goldberg, S. C. (1973) Drug and sociotherapy in the aftercare of schizophrenic patients. One-year relapse rates. Archives of General Psychiatry, 28, 5464.CrossRefGoogle ScholarPubMed
Hogarty, G. E. Goldberg, S. C. Schooler, N. R. & Ulrich, R. F. (1974) Drug and socio-therapy in the aftercare of schizophrenic patients. II. Two-year relapse rates. Archives of General Psychiatry, 31, 603–8.Google Scholar
Hogarty, G. E. Schooler, N. R., Ulrich, R. F., Mussare, F., Ferro, P. & Herron, E. (1979) Fluphenazine and social therapy in the aftercare of schizophrenic patients. Archives of General Psychiatry, 36, 1283–94.CrossRefGoogle ScholarPubMed
Leff, J. P. (1976) Schizophrenia and sensitivity to the family environment. Schizophrenia Bulletin, 2, 566–74.CrossRefGoogle Scholar
Leff, J. P. (1981) Clinical and methodological problems in interaction studies. In Epidemiological Impact of Psychotropic Drugs, (eds Tognoni, G., Bellantuono, C. and Lader, M.). Amsterdam: Elsevier Google Scholar
Leff, J. P. & Vaughn, C. (1981) The role of maintenance therapy and relatives' expressed emotion in relapse of schizophrenia: a two-year follow-up. British Journal of Psychiatry, 139, 102–4.CrossRefGoogle ScholarPubMed
Leff, J. P. & Wing, J. K. (1971) Trial of maintenance therapy in schizophrenia. British Medical Journal, iii, 599604.CrossRefGoogle Scholar
Orford, J. & Edwards, G. (1977) Alcoholism. Maudsley Monograph No 26. London: Oxford University Press Google Scholar
Priestley, D. (1979) Schizophrenia and the family: Part II. In Community Care for the Mentally Disabled, (eds Wing, J. K. and Olsen, R.). London: Oxford University Press Google Scholar
Sturgeon, D., Kuipers, L., Berkowitz, R., Turpin, G. & Leff, J. (1981) Psychophysiological responses of schizophrenic patients to high and low expressed emotion relatives. British Journal of Psychiatry, 138, 40–5.CrossRefGoogle ScholarPubMed
Tarrier, N., Vaughn, C. E., Lader, M. H. & Leff, J. P. (1979) Bodily reactions to people and events in schizophrenia. Archives of General Psychiatry, 36, 311–15.CrossRefGoogle Scholar
Vaughn, C. E. & Leff, J. P. (1976) The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125–37.CrossRefGoogle ScholarPubMed
Vaughn, C. E. & Leff, J. P. (1976) The measurement of expressed emotion in families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–65.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.