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While the efficacy of family psychoeducational interventions in the treatment of schizophrenia is now well documented, few data are available on its efficacy in major depression. This study aimed to verify the effectiveness of a family psychoeducational intervention according to the Falloon model on patients’ clinical status, social functioning and lifestyle and on relatives’ burden and social network. The study was coordinated by the Department of Psychiatry of the University of Naples SUN and carried out in 7 Italian mental health centres. In each centre, 8 patients with major depression and their relatives were recruited if they fulfilled the following criteria: a) diagnosis of unipolar major depression according to the DSM-IV; b) aged between 18 and 65 years; c) in charge to the local mental health centre for at least 6 months; d) at least one depressive episode in the last two years; e) living with at least one relative aged between 18 and 70 years. Recruited families have been randomly allocated to the experimental group, which received the psychoducational intervention for 6 months, or to the control group, which received the treatment as usual plus an informative brief intervention. 22 families have been treated with the experimental intervention and 22 with the control one. At the end of the intervention, patients’ clinical status and life-style significantly improved in the treated group, as well as family objective burden and social contacts. Family psychoeducational intervention are useful in reducing personal and family difficulties caused by depression and in improving patients’ lifestyles. [ABSTRACT FROM AUTHOR]

Introduction: Views on the causes and psychosocial consequences of schizophrenia of the Italian population, patients’ relatives and mental health professionals can influence detection and outcome of these disorders. Aims: To investigate the opinions on schizophrenia in a sample of 614 lay respondents, 465 mental health professionals and 709 key-relatives. Methods: The survey was conducted in 30 randomly selected geographical areas with the Questionnaire about Opinions on mental illness (QO). Results: The results show significant differences among the three groups as regards opinions about patients’ civil rights and social competence of patients with schizophrenia. In particular, the belief that patients’ behaviors are unpredictable is maintained by 18% of mental health workers and by 35% of family members and the general public. As regards causes, 68% of relatives, 20% of mental health workers and 34% of general public believe that schizophrenia is caused by psychosocial factors only. Forty-eight percent of the relatives affirmed that they are fully convinced of the usefulness of pharmacological treatment compared to 28% of professionals and 25% of the Italian population. With respect to civil rights, about half of the relatives is fully convinced that patients with schizophrenia should not have children compared to 17% of mental health workers and to 19% of the general public. Conclusions: These results underline the need to conduct sensitization campaigns about schizophrenia focused on specific aspects of the disease, such as unpredictability, civil rights and opportunities to recovery of patients, taking into account the target population to which they are addressed. [ABSTRACT FROM AUTHOR]

Introduction: Bipolar disorder is associated with high personal and social burden, impaired social functioning and high levels of disability. The psychoeducational family intervention, found to be effective in the treatment of schizophrenia, may be particularly useful for patients with bipolar disorder and their relatives. Aims & methods: This study, funded by the Italian Ministry of Health, coordinated by the Department of Psychiatry of the University of Naples SUN and carried out in 11 randomly selected mental health centres, included the following phases 1) development of informative materials; 2) training of 2 mental health workers per center; 3) random selection of 16 families of patients with bipolar disorder for each center: 8 being randomly allocated to the experimental group and 8 to the control group. Results: 62 families have been recruited. Mental health workers reported several advantages in conducting the intervention, in particular in the relationship with patients and families. Significant improvements have been reported in professional skills and relationships with colleagues. The advantages tend to increase over time. The main reported difficulties are lack of time to run the intervention, identification of appropriate families, excessive workload and the need to integrate this intervention with other work commitments. Conclusions: It is possible to provide psychoeducational family intervention for patients with bipolar I disorder and their families, after a relatively short period of training. In order to facilitate the dissemination of this intervention in routine conditions, a better planning of the activities of the mental health centers may be useful. [ABSTRACT FROM AUTHOR]

Introduction Psychoeducational family intervention (PFI) has been proposed to supplement pharmacotherapy in order to improve the clinical outcome of people with bipolar I disorder. Only a few studies have been carried out on the efficacy of PFI on patients' social functioning and on relatives' burden. Objectives to improve patients' social functioning and to reduce the level of family burden in relatives of people with bipolar I disorder. Aims to improve clinical outcome and social functioning of patients with bipolar I disorder, and to reduce family burden, in those receiving the experimental intervention compared with treatment as usual (TAU) group. Methods A multicentre, real-world, randomized, controlled, outpatient trial was carried out in 11 Italian mental health centres. Enrolled patients and key-relatives were consecutively allocated either to receive PFI and TAU or to a waiting list receiving TAU alone. Results 70 families were allocated to the experimental group and 67 to the control group. At the end of the intervention, a significant improvement in patients' clinical status and social functioning was found in the experimental group compared to TAU, as well as a significant reduction in the levels of relatives' subjective and objective burden. The effect of the intervention remained significant also after controlling for several confounding patient's socio-demographic and clinical factors. Conclusions PFI is effective in improving the clinical and social outcomes of patients with bipolar I disorder and of their relatives. [ABSTRACT FROM AUTHOR]

Introduction: Family burden, defined as the consequences for those in close contact with a severely disturbed psychiatric patient, is now well-documented in schizophrenia research, whereas very few data are available in affective disorders. Aims: To explore: [1)] the levels of family burden in a sample of key-relatives of patients with major depression; [2)] the professional and social support for relatives of patients with major depression disorder. Methods: 324 patients with major depression and their key-relatives were randomly recruited in 30 Italian mental health centres, randomly selected and stratified by geographical area and population density. Family burden was explored in relation to: [a)] patient''s clinical status and disability; [b)] relatives’ social and professional support. Results: Reduction of leisure (53% of the sample) and social activities (44%) were the most frequently reported sources of practical burden, whereas psychological burden was mainly due to sense of loss (75%) and worries for the future (61%). Family burden is higher in key-relatives with a lower education level (p< .05), and when patients’ symptomatology and social functioning are more severe. Key-relatives who can rely on a stronger support from social network and from mental health professionals have lower levels of family burden (p< .05). Conclusion: These results highlight the need to provide supportive interventions for patients with major depression and their key-relatives. [Copyright &y& Elsevier]

This paper describes the development and the validation of a questionnaire assessing the opinions of the relatives of patients with schizophrenia on the causes and the social consequences of the disorder. The final version of the questionnaire includes 28 items, grouped in four sub-scales (social restrictions, social distance, utility of treatments, biopsychosocial causes of schizophrenia), whose intra-rater reliability ranges from 0.36 to 0.84. Cronbach's alpha coefficient, which tests the content validity of the sub-scales, ranges from 0.56 to 0.66. Factor analysis identifies two factors (opinions on social consequences and the utility of treatments, and the beliefs on the causes of schizophrenia), which account for the 73% of the total variance. This questionnaire may be particularly useful to assess relatives'beliefs about schizophrenia and to target psychosocial interventions in the families of patients with schizophrenia.