Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Schizophrenia | Research article

Effectiveness of the Japanese standard family psychoeducation on the mental health of caregivers of young adults with schizophrenia: a randomised controlled trial

Authors: Nao Shiraishi, Norio Watanabe, Fujika Katsuki, Hajime Sakaguchi, Tatsuo Akechi

Published in: BMC Psychiatry | Issue 1/2019

Login to get access

Abstract

Background

This study examined the effects of the standard model of family psychoeducation (SM-FPE) in Japan on the mental health of relatives who care for young patients with a psychotic disorder.

Methods

Stratified by recent-onset/chronic psychosis, 74 caregivers of outpatients aged 30.1 years (mean) were randomly assigned to receive TAU (treatment as usual) alone or TAU plus SM-FPE. All outcomes were measured at baseline, at the end of the intervention (10 weeks), and 1 month post-intervention (14 weeks). The primary outcome was the trait anxiety of caregivers at 14 weeks. Secondary outcomes included caregivers’ state anxiety, psychological distress, care burden, and expressed emotion. Integrating these secondary outcomes, a conceptual framework of caregivers’ health state was assessed via structural equation modelling.

Results

Compared with TAU alone, SM-FPE plus TAU did not significantly improve all caregivers’ individual outcomes. Direct effects of the intervention were observed in the caregivers of chronic patients as significant improvements of their overall mental health state at 10 weeks, which indirectly continued until 14 weeks. However, such intervention effects were not observed in the caregivers of recent-onset patients.

Conclusions

The lack of effectiveness in the recent-onset stage suggests that the usefulness of the SM-FPE needs to be corroborated by further research.

Trial registration

The study protocol was retrospectively registered at ClinicalTrials.​gov (registration number: NCT01731977; date of registration: 22 November 2012).
Literature
1.
Global Burden of Disease Study C. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386(9995):743–800.CrossRef
2.
Awad AG, Voruganti LN. The burden of schizophrenia on caregivers: a review. PharmacoEconomics. 2008;26(2):149–62.PubMedCrossRef
3.
Kuipers E, Onwumere J, Bebbington P. Cognitive model of caregiving in psychosis. Br J Psychiatry. 2010;196(4):259–65.PubMedCrossRef
4.
Hoenig J, Hamilton MW. The schizophrenic patient in the community and his effect on the household. Int J Soc Psychiatry. 1966;12(3):165–76.PubMedCrossRef
5.
Addington J, Coldham EL, Jones B, Ko T, Addington D. The first episode of psychosis: the experience of relatives. Acta Psychiatr Scand. 2003;108(4):285–9.PubMedCrossRef
6.
Bibou-Nakou I, Dikaiou M, Bairactaris C. Psychosocial dimensions of family burden among two groups of carers looking after psychiatric patients. Soc Psychiatry Psychiatr Epidemiol. 1997;32(2):104–8.PubMedCrossRef
7.
Jansen JE, Gleeson J, Cotton S. Towards a better understanding of caregiver distress in early psychosis: a systematic review of the psychological factors involved. Clin Psychol Rev. 2015;35:56–66.PubMedCrossRef
8.
Hazel NA, McDonell MG, Short RA, Berry CM, Voss WD, Rodgers ML, Dyck DG. Impact of multiple-family groups for outpatients with schizophrenia on caregivers' distress and resources. Psychiatr Serv. 2004;55(1):35–41.PubMedCrossRef
9.
Hesse K, Klingberg S. Examining the cognitive model of caregiving--a structural equation modelling approach. Psychiatry Res. 2014;217(3):171–6.PubMedCrossRef
10.
Pharoah F, Mari J, Rathbone J, Wong W. Family intervention for schizophrenia. Cochrane Database Syst Rev. 2010;12:CD000088.
11.
Sin J, Norman I. Psychoeducational interventions for family members of people with schizophrenia: a mixed-method systematic review. J Clin Psychiatry. 2013;74(12):e1145–62.PubMedCrossRef
12.
Abramowitz IA, Coursey RD. Impact of an educational support group on family participants who take care of their schizophrenic relatives. J Consult Clin Psychol. 1989;57(2):232–6.PubMedCrossRef
13.
Smith JV, Birchwood MJ. Specific and non-specific effects of educational intervention with families living with a schizophrenic relative. Br J Psychiatry. 1987;150:645–52.PubMedCrossRef
14.
Gutierrez-Maldonado J, Caqueo-Urizar A, Ferrer-Garcia M. Effects of a psychoeducational intervention program on the attitudes and health perceptions of relatives of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2009;44(5):343–8.PubMedCrossRef
15.
Leavey G, Gulamhussein S, Papadopoulos C, Johnson-Sabine E, Blizard B, King M. A randomized controlled trial of a brief intervention for families of patients with a first episode of psychosis. Psychol Med. 2004;34(3):423–31.PubMedCrossRef
16.
Posner CM, Wilson KG, Kral MJ, Lander S, McIlwraith RD. Family psychoeducational support groups in schizophrenia. Am J Orthop. 1992;62(2):206–18.CrossRef
17.
Szmukler G, Kuipers E, Joyce J, Harris T, Leese M, Maphosa W, Staples E. An exploratory randomised controlled trial of a support programme for carers of patients with a psychosis. Soc Psychiatry Psychiatr Epidemiol. 2003;38(8):411–8.PubMedCrossRef
18.
Gutierrez-Maldonado J, Caqueo-Urizar A. Effectiveness of a psycho-educational intervention for reducing burden in Latin American families of patients with schizophrenia. Qual Life Res. 2007;16(5):739–47.PubMedCrossRef
19.
Chan SW, Yip B, Tso S, Cheng BS, Tam W. Evaluation of a psychoeducation program for Chinese clients with schizophrenia and their family caregivers. Patient Educ Couns. 2009;75(1):67–76.PubMedCrossRef
20.
de Mamani AW, Suro G. The effect of a culturally informed therapy on self-conscious emotions and burden in caregivers of patients with schizophrenia: A randomized clinical trial. Psychotherapy (Chic). 2016;53(1):57–67.CrossRef
21.
22.
Ito J, Oshima I, Tsukada K, Koisikawa H. Comprehensive treatment of schizophrenia. Tokyo: Springer Japan; 2002.
23.
Katsuki F, Takeuchi H, Konishi M, Sasaki M, Murase Y, Naito A, Toyoda H, Suzuki M, Shiraishi N, Kubota Y, et al. Pre-post changes in psychosocial functioning among relatives of patients with depressive disorders after brief multifamily psychoeducation: a pilot study. BMC Psychiatry. 2011;11(1):56.PubMedPubMedCentralCrossRef
24.
Katsuki F, Takeuchi H, Watanabe N, Shiraishi N, Maeda T, Kubota Y, Suzuki M, Yamada A, Akechi T. Multifamily psychoeducation for improvement of mental health among relatives of patients with major depressive disorder lasting more than one year: study protocol for a randomized controlled trial. Trials. 2014;15:320.PubMedPubMedCentralCrossRef
25.
Suzuki M, Yamada A, Watanabe N, Akechi T, Katsuki F, Nishiyama T, Imaeda M, Miyachi T, Otaki K, Mitsuda Y, et al. A failure to confirm the effectiveness of a brief group psychoeducational program for mothers of children with high-functioning pervasive developmental disorders: a randomized controlled pilot trial. Neuropsychiatr Dis Treat. 2014;10:1141–53.PubMedPubMedCentralCrossRef
26.
APA. Diagnostic and Stastistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR®). Washington, DC: American Psychiatric Association; 2000.
27.
Miller TJ, McGlashan TH, Rosen JL, Cadenhead K, Cannon T, Ventura J, McFarlane W, Perkins DO, Pearlson GD, Woods SW. Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull. 2003;29(4):703–15.PubMedCrossRef
28.
Pocock S. Clinical trials: a practical approach. New York: John Wiley & Sons; 1983.
29.
Shiraishi N, Watanabe N, Kinoshita Y, Kaneko A, Yoshida S, Furukawa TA, Akechi T. Brief psychoeducation for schizophrenia primarily intended to change the cognition of auditory hallucinations: an exploratory study. J Nerv Ment Dis. 2014;202(1):35–9.PubMedCrossRef
30.
Yamaguchi H, Takahashi A, Takano A, Kojima T. Direct effects of short-term psychoeducational intervention for relatives of patients with schizophrenia in Japan. Psychiatry Clin Neurosci. 2006;60(5):590–7.PubMedCrossRef
31.
Inada T, Inagaki A. Psychotropic dose equivalence in Japan. Psychiatry Clin Neurosci. 2015;69(8):440–7.PubMedCrossRef
32.
Spielberger CD. Manual for the state-trait anxiety inventory, STAI-from Y. Palo Alto: Consulting Psychologists Press; 1983.
33.
Nakazato K, Mizuguchi T. Development and validation of Japanese version of state-trait anxiety inventory. Shinshin Igaku. 1982;22:107–12.
34.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.PubMedCrossRef
35.
Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, Tachimori H, Iwata N, Uda H, Nakane H, et al. The performance of the Japanese version of the K6 and K10 in the world mental health survey Japan. Int J Methods Psychiatr Res. 2008;17(3):152–8.PubMedCrossRefPubMedCentral
36.
Andrews G, Slade T. Interpreting scores on the Kessler psychological distress scale (K10). Aust N Z J Public Health. 2001;25(6):494–7.PubMedCrossRef
37.
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.PubMedCrossRef
38.
Goncalves-Pereira M, Gonzalez-Fraile E, Santos-Zorrozua B, Martin-Carrasco M, Fernandez-Catalina P, Dominguez-Panchon AI, Munoz-Hermoso P, Ballesteros J. Assessment of the consequences of caregiving in psychosis: a psychometric comparison of the Zarit burden interview (ZBI) and the involvement evaluation questionnaire (IEQ). Health Qual Life Outcomes. 2017;15(1):63.PubMedPubMedCentralCrossRef
39.
Schreiner AS, Morimoto T, Arai Y, Zarit S. Assessing family caregiver's mental health using a statistically derived cut-off score for the Zarit burden interview. Aging Ment Health. 2006;10(2):107–11.PubMedCrossRef
40.
Arai Y, Kudo K, Hosokawa T, Washio M, Miura H, Hisamichi S. Reliability and validity of the Japanese version of the Zarit caregiver burden interview. Psychiatry Clin Neurosci. 1997;51(5):281–7.PubMedCrossRef
41.
Arai Y, Tamiya N, Yano E. The short version of the Japanese version of the Zarit caregiver burden interview (J-ZBI_8): its reliability and validity. Nihon Ronen Igakkai zasshi Jpn J Geriatr. 2003;40(5):497–503.CrossRef
42.
Kumamoto K, Arai Y. Validation of 'personal strain' and 'role strain': subscales of the short version of the Japanese version of the Zarit burden interview (J-ZBI_8). Psychiatry Clin Neurosci. 2004;58(6):606–10.PubMedCrossRef
43.
Kavanagh DJ, O'Halloran P, Manicavasagar V, Clark D, Piatkowska O, Tennant C, Rosen A. The family attitude scale: reliability and validity of a new scale for measuring the emotional climate of families. Psychiatry Res. 1997;70(3):185–95.PubMedCrossRef
44.
Kavanagh DJ, Pourmand D, White A, Robertson D, Halford K, Vaughan K. Predictive validity of the family attitude scale in people with psychosis. Psychiatry Res. 2008;160(3):356–63.PubMedCrossRef
45.
Fujita H, Shimodera S, Izumoto Y, Tanaka S, Kii M, Mino Y, Inoue S. Family attitude scale: measurement of criticism in the relatives of patients with schizophrenia in Japan. Psychiatry Res. 2002;110(3):273–80.PubMedCrossRef
46.
Link BG, Cullen FT, Elmer S, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev. 1989;54:400–23.CrossRef
47.
Shimotsu S, Sakamoto S, Horikawa N, Sakano Y. Reliability and validity of the Link's devaluation-discrimination scale. Seishinka Chiryogaku. 2006;21(5):521–8.
48.
Schermelleh-Engell K, Moosbrugger H, Müller H. Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res Online. 2003;8(2):23–74.
49.
van Wijngaarden B, Schene AH, Koeter M, Vazquez-Barquero JL, Knudsen HC, Lasalvia A, McCrone P. Caregiving in schizophrenia: development, internal consistency and reliability of the Involvement Evaluation Questionnaire--European Version. EPSILON Study 4. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. Br J Psychiatry Suppl. 2000;39:s21–7.CrossRef
50.
Hidano T, Fukuhara M, Iwawaki S, Soga S, Spielberger CD. The manual of state-trait anxiety inventory-form JYZ. Tokyo: JITSUMUKYOIKU-SHUPPAN; 2000.
51.
Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Bmj. 2010;340:c869.PubMedPubMedCentralCrossRef
Metadata
Title
Effectiveness of the Japanese standard family psychoeducation on the mental health of caregivers of young adults with schizophrenia: a randomised controlled trial
Authors
Nao Shiraishi
Norio Watanabe
Fujika Katsuki
Hajime Sakaguchi
Tatsuo Akechi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2019
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-019-2252-y

Other articles of this Issue 1/2019

BMC Psychiatry 1/2019 Go to the issue

Research article

How do adolescents with depression experience improvement in psychodynamic psychotherapy? A qualitative study

Research article

Crimes by people with schizophrenia in Korea: comparison with the general population

Study protocol

Efficacy and cost-effectiveness of an unguided, internet-based self-help intervention for social anxiety disorder in university students: protocol of a randomized controlled trial

Study protocol

A regional systems intervention for suicide prevention in the Netherlands (SUPREMOCOL): study protocol with a stepped wedge trial design

Research article

Daily variation in post traumatic stress symptoms in individuals with and without probable post traumatic stress disorder

Research article

Prediction of psychiatric comorbidity on premature death in a cohort of patients with substance use disorders: a 42-year follow-up