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

Behavioural family intervention vs. family support intervention (> 5 sessions)
RCT (1-)
There are no differences between the two interventions related to hospital
readmissions (n = 528; RR = 0.98; 95% CI: between 0.1 and 1.12) 86 .
Systemic family therapy vs. standard treatment
RCT (1-)
It is observed that patients who receive systemic family therapy improve
during the treatment in readmission rates (p = 0.273); relapses (p = 0.030)
and treatment adherence (p = 0.009). However, after 2 years there are no
differences between the two groups 87 .
Inclusion of the patient in family interventions
SR (1+)
When the user is included in the family sessions, there is evidence that
shows that family intervention reduces the levels of relapses once the treatment
has finished (n = 269; RR = 0.68; 95% CI between 0.50 and 0.91) 8 .
Family interventions combined with other interventions
RCT (1+)
RCT (1++)
When comparing family interventions that incorporated another psychosocial
intervention (OPT group) vs. standard treatment, the latter presented
significant improvements in the clinical severity rates (41%), disability
(39%) and stress perceived by carers (48%) 24 months after the intervention
89 .
35% of the patients from the OPT group satisfied the criteria of complete
recovery after 24 months, compared with 10% of the patients from
the standard treatment group. The observation of significant improvements
in all the parameters when applying the standard treatment for 24 months
reflects the high clinical standards that exist in the centres that participated
in the project 89 .
In one out of every four cases with recent-onset schizophrenia or with
a first episode of schizophrenia, as well as 40% of the chronic cases, no type
of improvement was observed at the end of two years’ OPT treatment 89 .
Of the patients who received treatment (n=90) those from the group
that received FP+SST+PT did not present any relapse in 12 months; those
from the group of FP+PT (19%); those from the group of SST-PT (20%)
and those from the control group 38% (p=0.007).
On performing the same analysis with the subgroup of patients who
presented no difficulty in taking the medication (n=78), a smaller percentage
of relapses was observed in the group FP+ PT (11%; p=0.012), a similar
percentage of relapses in the group SST+PT (17%; SST p=0.084), a
similar percentage in the control group PT (32%) and again a clear additive
effect in the combined group without relapses in 12 months (0%) 74 .
60 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS