Effects of Family Psychoeducation on Expressed Emotion and Burden of Care in First-Episode Psychosisa Prospective Observational Study

  1. González-Blanch Bosch, César 1
  2. Martín Muñoz, Vanessa 1
  3. Pardo García, Marta 1
  4. Martínez García, Obdulia 1
  5. Álvarez Jiménez, Mario 1
  6. Rodríguez Sánchez, José Manuel 1
  7. Vázquez Barquero, José Luis 1
  8. Crespo Facorro, Benedicto 1
  1. 1 Hospital Universitario Marqués de Valdecilla
    info

    Hospital Universitario Marqués de Valdecilla

    Santander, España

    ROR https://ror.org/01w4yqf75

Journal:
The Spanish Journal of Psychology

ISSN: 1138-7416

Year of publication: 2010

Volume: 13

Issue: 1

Pages: 389-395

Type: Article

DOI: 10.1017/S1138741600003942 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: The Spanish Journal of Psychology

Sustainable development goals

Abstract

The present study aimed to examine the levels and interactions of family burden (FB) and expressed emotion (EE) in first episode psychosis (FEP) patients and, secondly, to observe the potential change after a brief psychoeducational group intervention implemented in a real world clinical setting. Twenty-three key relatives of FEP patients received a brief psychoeducational group intervention. FB and EE were assessed before and after the intervention. EE-change and correlations between variables were examined. Half of the sample of key-relatives showed high levels of EE. No severe family burden was observed. FB and EE did not change after the intervention. Family subjective and objective burden were correlated with emotional overinvolvement, but not with criticism. Brief psychoeducational groups may not be sufficient to reduce FB and EE associated to the experience of caregiving for a family member with a first-episode psychotic disorder.

Funding information

The authors gratefully acknowledge the participation of the families involved in the study. Thanks also to Joe Buckby (EPPIC, Melbourne, Australia) for his helpful comments on this manuscript. Funding for this study was provided by the Instituto de Salud Carlos III, grant no. FIS PI05/0697 Correspondence concerning this article should be addressed to César González-Blanch Hospital Universitario “Marqués de Valdecilla”. Unidad de Investigación en Psiquiatría de Cantabria. Avda. Valdecilla s/n. Edificio 2 de Noviembre. Planta 2ª. 39008 Santander. Cantabria. (Spain). Phone: +34-942202537. Fax: +34-942203447. E-mail: cgblanch@terra.es

Bibliographic References

  • Addington, J., Collins, A., McCleery, A., & Addington, D. (2005). The role of family work in early psychosis. Schizophrenia Research, 79(1), 77-83. (Pubitemid 41362595)
  • Álvarez-Jiménez, M., Gleeson, J. F., Cotton, S. M., Wade, D., Crisp, K., Yap, M. B., et al. (2010). Differential predictors of critical comments and emotional over-involvement in firstepisode psychosis. Psychological Medicine, 40(1), 63-72.
  • Álvarez-Jiménez, M., González-Blanch, C., Pérez-Pardal, T., Rodríguez-Sánchez, J. M., & Crespo-Facorro, B. (2007). Cognitive therapy in early psychosis and "at risk mental state". Actas Españolas de Psiquiatría, 35(1), 67-76.
  • Askey, R., Gamble, C., & Gray, R. (2007). Family work in firstonset psychosis: a literature review. Journal of Psychiatric and Mental Health Nursing, 14(4), 356-365.
  • Awad, A. G., & Voruganti, L. N. (2008). The burden of schizophrenia on caregivers: a review. Pharmacoeconomics, 26(2), 149-162.
  • Birchwood, M., & Macmillan, F. (1993). Early intervention in schizophrenia. Australian and New Zealand Journal of Psychiatry, 27(3), 374-378.
  • Brown, G. W., Birley, J. L., & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121(562), 241-258.
  • Cañive, J. M., Sanz-Fuentenebro, J., Tuason, V. B., Vázquez, C., Schrader, R. M., Alberdi, J., et al. (1993). Psychoeducation in Spain. Hospital and Community Psychiatry, 44(7), 679-681.
  • Crespo-Facorro, B., Pérez-Iglesias, R., Ramírez-Bonilla, M., Martínez-García, O., Llorca, J., & Vázquez- Barquero, J. L. (2006). A practical clinical trial comparing haloperidol, risperidone, and olanzapine for the acute treatment of first-episode nonaffective psychosis. Journal of Clinical Psychiatry, 67(10), 1511-1521. (Pubitemid 44787432)
  • Gleeson, J., Jackson, H. J., Stavely, H., & Burnett, P. (1999). Family intervention in early psychosis. In P. D. McGorry y H. J. Jackson (Eds.), The recognition and management of early psychosis. A preventive approach (pp. 376-406). Cambridge: Cambridge University Press.
  • Jackson, H. J., Smith, N., & McGorry, P. (1990). Relationship between expressed emotion and family burden in psychotic disorders: an exploratory study. Acta Psychiatrica Scandinavica, 82(3), 243-249. (Pubitemid 20329010)
  • Jeppesen, P., Petersen, L., Thorup, A., Abel, M. B., Oehlenschlaeger, J., Christensen, T. O., et al. (2005). Integrated treatment of first-episode psychosis: effect of treatment on family burden: OPUS trial. British Journal of Psychiatry. Supplement, 48, s85-90.
  • King, S., & Dixon, M. J. (1999). Expressed emotion and relapse in young schizophrenia outpatients. Schizophrenia Bulletin, 25(2), 377-386. (Pubitemid 29272512)
  • Linszen, D., Dingemans, P., Van der Does, J. W., Nugter, A., Scholte, P., Lenior, R., et al. (1996). Treatment, expressed emotion and relapse in recent onset schizophrenic disorders. Psychological Medicine, 26(2), 333-342. (Pubitemid 26075206)
  • Martens, L., & Addington, J. (2001). The psychological well-being of family members of individuals with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 36(3), 128-133. (Pubitemid 32544857)
  • Moller-Leimkuhler, A. M., & Obermeier, M. (2008). Predicting caregiver burden in first admission psychiatric patients. 2-year follow-up results. European Archives of Psychiatry and Clinical Neuroscience, 258(7), 406-413.
  • Otero, V., Navascu, S. D., & Rebolledo, S. (1990). Escala de desempeño psicosocial. Adaptación española del SBAS (Social Behaviour Assessment Schedule). Psiquis, 11, 395-401.
  • Patterson, P., Birchwood, M., & Cochrane, R. (2005). Expressed emotion as an adaptation to loss: prospective study in first-episode psychosis. British Journal of Psychiatry. Supplement, 48, s59-64.
  • Pharoah, F., Mari, J., Rathbone, J., & Wong, W. (2006). Family intervention for schizophrenia. Cochrane Database Systematic Reviews, 4, CD000088.
  • Platt, S., Weyman, A., Hirsch, S., & Hewett, S. (1980). The Social Behaviour Assessment Schedule (SBAS): Rationale, Contents, Scoring and Reliability of a New Interview Schedule. Social Psychiatry, 15, 43-55. (Pubitemid 10185972)
  • Raj, L., Kulhara, P., & Avasthi, A. (1991). Social burden of positive and negative schizophrenia. International Journal of Social Psychiatry, 37(4), 242-250.
  • Raune, D., Kuipers, E., & Bebbington, P. E. (2004). Expressed emotion at first-episode psychosis: investigating a carer appraisal model. British Journal of Psychiatry, 184, 321-326. (Pubitemid 38491167)
  • Santos, A., Espina, A., Pumar, B., Gonzalez, P., Ayerbe, A., & Garcia, E. (2001). Longitudinal study of the stability of expressed emotion in families of schizophrenic patients: a 9-month followup. The Spanish Journal of Psychology, 4(1), 65-71. (Pubitemid 33654168)
  • Scazufca, M., & Kuipers, E. (1996). Links between expressed emotion and burden of care in relatives of patients with schizophrenia. British Journal of Psychiatry, 168(5), 580-587. (Pubitemid 26173351)
  • Scazufca, M., & Kuipers, E. (1998). Stability of expressed emotion in relatives of those with schizophrenia and its relationship with burden of care and perception of patients' social functioning. Psychological Medicine, 28(2), 453-461. (Pubitemid 28197560)
  • Smith, J., Birchwood, M., Cochrane, R., & George, S. (1993). The needs of high and low expressed emotion families: a normative approach. Social Psychiatry and Psychiatric Epidemiology, 28(1), 11-16. (Pubitemid 23086913)
  • Szmukler, G., Kuipers, E., Joyce, J., Harris, T., Leese, M., Maphosa, W., et al. (2003). An exploratory randomised controlled trial of a support programme for carers of patients with a psychosis. Social Psychiatry and Psychiatric Epidemiology, 38(8), 411-418. (Pubitemid 37160814)
  • Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20(5), 633-666. (Pubitemid 30326806)
  • Wiedemann, G., Rayki, O., Feinstein, E., & Hahlweg, K. (2002). The Family Questionnaire: development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Research, 109(3), 265-279. (Pubitemid 34311983)