CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

A family intervention of more than 5 sessions indicates a significant
reduction in the burden perceived by family caregivers (n = 48; WMD =
-7.01; 95% CI between -10.8 and -3.3) 81 and (n = 60; WMD = -0.4; 95% CI:
between -0.7 and -0.1) 82 .
A family intervention of more than 5 sessions, compared with standard
treatment, favours the reduction of expressed emotion levels within the family
(3 RCT; n = 164; RR = 0.68; 95% CI: between 0.5 and 0.9; NNT = 4;
95% CI: between 3 and 10) 80 .
Patients who have received family intervention have a higher quality
of life than those who did not receive it (n = 213; WMD = 19.18; 95% CI
between 9.8 and 28.6) after two years’ treatment 80 .
There is not sufficient evidence to determine if family interventions
reduce the levels of negative symptoms (MSANS: n = 41; WMD = -1.20;
95% CI: between -2.78 and 0.38) 79 or if they improve social functioning
(Social Functioning Scale: n = 69; WMD = -1.60; 95% CI: between -7.07
and 3.87) 78 .
Sufficient evidence has not been found, either, that determines if family
intervention reduces the suicide rate (7 RCT, n = 377; RR = 0.79; 95% CI
between 0.35 and 1.78) 80 .
SR (1-)
RCT (1-)
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Duration of the interventions
When the programme is provided for a period of 6 months or more, or for
more than 10 scheduled sessions, there is evidence that indicates that family
intervention reduces relapses at 4 to 15 months’ follow-up after treatment (n
= 165; RR= 0.65; 95% CI: between 0.47 and 0.90) 8 .
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Family intervention formats
Single-family intervention vs. multi-family intervention
There are no differences between multi-family intervention and single-family
interventions with respect to relapses at 13 to 24 months (n = 508; RR =
0.97, 95% CI: between 0.76 and 1.25) 8 .
No differences were found, either, between the two types of family
interventions regarding experiencing greater pharmacological treatment adherence
(n = 172; RR = 1.0; 95% CI: between 0.5 and 2.0) 84 .
Leff et al 85 indicate that the people who received single-family intervention,
compared with those who received multi-family intervention, were
able to lead more independent lives (n = 23; RR = 2.18; 95% CI: between
1.1 and -4.4).
In the study by Montero et al. 88 they indicate that (although both techniques
improved the patient’s clinical situation), the families that received
individual behavioural approach therapy had better results in social functioning,
doses of antipsychotic medication and psychotic symptoms (p< 0.05),
than the families that received group format (there were no differences in the
relapse or readmission rates).
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RCT (1-)
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CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 59