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Multiple-Family Groups and Psychoeducation in the Treatment of Schizophrenia

William R. McFarlane, MD; Ellen Lukens, PhD; Bruce Link, PhD; Robert Dushay, PhD; Susan A. Deakins, MD; Margaret Newmark, CSW; Edward J. Dunne, PhD; Bonnie Horen, MA; Joanne Toran, MPA
Arch Gen Psychiatry. 1995;52(8):679-687. doi:10.1001/archpsyc.1995.03950200069016.
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Objective:  To compare outcomes in psychoeducational multiple-family group treatment vs psychoeducational single-family treatment.

Method:  A total of 172 acutely psychotic patients, aged 18 to 45 years, with DSM-III-R schizophrenic disorders were randomly assigned to single- or multiple-family psychoeducational treatment at six public hospitals in the state of New York. Psychotic relapse, symptom status, medication compliance, rehospitalization, and employment were assessed independently during 2 years of supervised treatment.

Results:  The multiple-family groups yielded significantly lower 2-year cumulative relapse rates than did the single-family modality (16% vs 27%) and achieved markedly lower rates in patients whose conditions had not remitted at index hospital discharge (13% vs 33%). The relapse hazard ratio between treatments was 1:3. The relapse rate for both modalities was less than half the expected rate (65% to 80% for 2 years) for patients receiving individual treatment and medication. Rehospitalization rates and psychotic symptoms decreased significantly, and medication compliance was high, to an equal degree in both modalities. Psychoeducational multiple-family groups were more effective than single-family treatment in extending remission, especially in patients at higher risk for relapse, with a cost-benefit ratio of up to 1:34.

Conclusion:  Psychoeducational multiple-family groups were more effective than single-family treatment in extending remission, especially in patients at higher risk for relapse, with a cost-benefit ratio of up to 1:34.

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