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1. Family psychoeducational interventions for schizophrenia in routine settings: impact on patients' clinical status and social functioning and on relatives' burden and resources

Author

Vincenzo Delcuratolo, Riccardo Curreli, Luisa Maresca, Rosa Salmeri, Emi Bondi, Laura Pezzenati, Andrea Fiorillo, Graziella Campo, Gennaro Cerullo, Flavia Dagianti, Aniello Esposito, Corrado De Rosa, Rita Di Nunzio, Claudio Malangone, Lucia Matrella, Monica Prezioso, Annarita Sasso, Francesco Bardicchia, Rosario Cantone, Gruppo Di Lavoro, Mauro Raffaeli, Giuseppina Robustelli Test, Grazia Favata, Michele Di Lella, Barbara Scandone, Paola Innocente, Giovanna Cavaliere, Lorenza Magliano, Mario Scordato, Rossella Bellini, Angela Scorsino, Elisabetta Biscussi, Maria Giannini, Matteo Folla, Francesco Degl'Innocent, Luisa Gargiulo, Mario Maj, Silvana Miscali, Lucetta Casale, Floralba Gentile, Stefania Lucania, Magliano, Lorenza, Fiorillo, Andrea, Malangone, C, DE ROSA, C, Favata, G, Sasso, A, Prezioso, M, Pezzenati, L, Gentile, F, Casale, L, Bondi, E, Test, Gr, DI LELLA, M, Biscussi, E, Degl'Innocent, F, Bellini, R, DI NUNZIO, R, Matrella, L, Salmeri, R, Cantone, R, Gargiulo, L, Esposito, A, Delcuratolo, V, Giannini, M, Maresca, L, Cavaliere, G, Scandone, B, Folla, M, Raffaeli, M, Innocente, P, Dagianti, F, Lucania, S, Scorsino, A, Bardicchia, F, Cerullo, G, Curreli, R, Miscali, S, Scordato, M, Campo, G, Maj, Mario, and GRUPPO DI, Lavoro

Subjects
Male, medicine.medical_specialty, MEDLINE, Severity of Illness Index, Resource Allocation, Disability Evaluation, Social support, Catchment Area, Health, Cost of Illness, Intervention (counseling), Severity of illness, Prevalence, medicine, Humans, Family, Social Behavior, Psychiatry, Health Education, Demography, Social network, business.industry, Public Health, Environmental and Occupational Health, Social Support, Middle Aged, medicine.disease, Mental health, Psychiatry and Mental health, Mental Health, Italy, Schizophrenia, Family Therapy, Female, Health education, Psychology, business
Abstract

SUMMARYObjective — This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' clinical status and disability and relatives' burden and perceived support. Methods — The study has been carried out in 17 mental health centres. In each of them, 2 professionals were trained in a psychoeducational intervention and applied it for six months with families of users with schizophrenia. At baseline and six months later, patients' clinical status and disability, and relatives' burden, social network and professional support were assessed by validated tools. Results — Of the seventy-one recruited families, 48 (68%) completed the intervention. At six months, a significant improvement was found in patients' clinical status and social functioning, as well as in relatives' burden and social and professional support. In particular, the percentage of patients with poor or very poor global social functioning dropped from 50% to 27% at six months. Forty percent of patients and 45% of relatives reported a significant improvement in their social contacts over the intervention period. Conclusions — The results of this study confirm the hypothesis that psychoeducational family interventions may have a significant effect on social outcome and family burden in schizophrenia when provided in routine conditions.Declaration of Interest: none of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by grants received from the “M. Lugli” Foundation (grant n. 2/18/8) and from the National Institute of Health, Italy (grant no. 1AL/F3).

Published
2006
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2. Benefits and difficulties in implementing family psychoeducational interventions for schizophrenia in mental health services: results from a multicentre Italian study

Author

Paola Innocente, Angela Scorsino, Corrado De Rosa, Barbara Scandone, Luisa Gargiulo, Mario Maj, Francesco Degl'Innocenti, Lucia Matrella, Rossella Bellini, Rita Di Nunzio, Andrea Fiorillo, Michele Di Lella, Graziella Campo, Anna Malacarne, Carla Sodde, Francesco Bardicchia, Giovanna Cavaliere, Giuseppina Robustelli Test, Laura Pezzenati, Rosa Salmeri, Cinzia Mameli, Luigi D'Ambra, Mauro Raffaeli, Flavia Dagianti, Lorenza Magliano, Grazia Favata, Elisabetta Biscussi, Gruppo Di Lavoro, Aniello Esposito, Monica Prezioso, Mario Scordato, Maria Giannini, Matteo Folla, Stefania Lucania, Floralba Gentile, Riccardo Curreli, Luisa Maresca, Silvana Miscali, Lucetta Casale, Gennaro Cerullo, Vincenzo Delcuratolo, Claudio Malangone, Annarita Sasso, Rosario Cantone, Emi Bondi, Magliano, Lorenza, Fiorillo, Andrea, Malangone, C, DE ROSA, C, Favata, G, Sasso, A, Prezioso, M, Pezzenati, L, Gentile, F, Casale, L, Bondi, E, Test, Gr, DI LELLA, M, Biscussi, E, Degl'Innocenti, F, Bellini, R, DI NUNZIO, R, Matrella, L, Salmeri, R, Cantone, R, Gargiulo, L, Esposito, A, Delcuratolo, V, Giannini, M, Maresca, L, Cavaliere, G, Scandone, B, Folla, M, Raffaeli, M, Innocente, P, Dagianti, F, Lucania, S, Scorsino, A, Bardicchia, F, Cerullo, G, Curreli, R, Miscali, S, Scordato, M, Campo, G, Mameli, C, Sodde, C, D'Ambra, L, Malacarne, A, and Maj, Mario

Subjects
Adult, Male, Mental Health Services, medicine.medical_specialty, Epidemiology, Schizophrenia (object-oriented programming), Training course, Psychological intervention, Psychoeducational intervention, Risk Assessment, Professional-Family Relations, Intervention (counseling), medicine, Humans, Psychiatry, Health Education, business.industry, Public Health, Environmental and Occupational Health, Mental health, Clinical Practice, Psychiatry and Mental health, Italy, Family medicine, Schizophrenia, Female, business
Abstract

SUMMARYAims – This study aims to explore: a) the feasibility of psycho-educational interventions for families of users with schizophrenia in clinical practice by trained staff; b) the benefits and problems encountered by professionals in the use of these interventions. Methods – 46 professionals from 23 Italian Mental Health Sen'ices (MHS) attended at a three-module training course in psycho-educational interventions and four supervisions in the subsequent year. Following the course, participants provided the intervention to families of users with schizophrenia. The difficulties and benefits encountered by trainees to use the intervention were registered on the Family Intervention Schedule.Results – 83% of the participants completed the training course. Following the course, the intervention started in 71 families from 17 MHS. 76% of trainees provided the intervention to 2-5 families, while 13% of them only held informative sessions on schizophrenia. During the supervision period, the organisational difficulties experienced by the professionals were stable, while the benefits increased. Differences in benefits and difficulties were detected in relation to the trainees’ experience and professional roles. Conclusions – It is possible to introduce psycho-educational interventions in MHS after a relatively brief period of training and supervision of the staff. Organisational difficulties need to be addressed to increase the dissemination of these interventions on a large scale.Declaration of Interest: None of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by grants received from the “M. Lugli” Foundation (grant n. 2/18/8) and from the National Institute of Health, Italy (grant no. 1AL/F3).

Published
2005
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3. Family burden in bipolar disorders: results from the Italian Mood Disorders Study (IMDS).

Author

Magliano L, Orrico A, Fiorillo A, Del Vecchio H, Castiello G, Malangone C, De Rosa C, Capuano V, Maj M, Torchio E, Franzoi V, Pingani L, Curti C, Spanarello S, Scattina M, Fuchs H, Test GR, Ferrigno J, Minciotti E, Innocente P, Bardicchia F, Galli A, La Rovere R, Maroncelli M, Iapichino S, Pannozzo M, Nuccetelli F, Di Nunzio R, Armellino R, Palladino C, Delcuratolo V, Cadoni M, Cannas A, Caniglia A, and Cudia M

Subjects
Female, Humans, Italy, Male, Middle Aged, Bipolar Disorder therapy, Cost of Illness, Family Health
Abstract

Aims: To explore: a) the burden of care, and the professional and social support in relatives of patients with bipolar disorders; b) the psychosocial interventions provided to patients and their families by Italian mental health centres., Methods: 342 outpatients with a bipolar disorder and their key-relatives were randomly recruited in 26 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; c) interventions received by patients and their families; d) geographical area., Results: In the previous two months, global functioning was moderately impaired in 36% of the patients, and severely impaired in 34% of them. Twenty-one percent of patients attended a rehabilitative programme, and 3% of their families received a psychoeducational intervention. Burden was higher when patient's symptoms and disability were more severe, the relatives had poorer psychological support and help in emergencies by the social network, and the family lived in Southern Italy. Differences in family burden in relation to geographical area disappeared when psychosocial interventions were provided., Conclusion: This study highlights the need to increase the availability of rehabilitative interventions for patients with bipolar disorders and of psychological support for their families, especially in Southern Italy.

Published
2009

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