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Effects of Family Psychoeducation on Expressed Emotion and Burden of Care in First-Episode Psychosis: A Prospective Observational Study

Published online by Cambridge University Press:  10 January 2013

César González-Blanch ,
Vanessa Martín-Muñoz ,
Gema Pardo-García ,
Obdulia Martínez-García ,
Mario Álvarez-Jiménez ,
José Manuel Rodríguez-Sánchez ,
José Luis Vázquez-Barquero  and
Benedicto Crespo-Facorro
César González-Blanch*
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
Vanessa Martín-Muñoz
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
Gema Pardo-García
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
Obdulia Martínez-García
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
Mario Álvarez-Jiménez
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
José Manuel Rodríguez-Sánchez
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
José Luis Vázquez-Barquero
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
Benedicto Crespo-Facorro
Affiliation:
Hospital Universitario Marqués de Valdecilla (Spain)
*
Correspondence concerning this article should be addressed to César González-Blanch Hospital Universitario “Marqués de Valdecilla”. Unidad de Investigación en Psiquiatría de Cantabria. Avda. Valdecilla s/n. Edificio 2 de Noviembre. Planta 2a. 39008 Santander. Cantabria. (Spain). Phone: +34-942202537. Fax: +34-942203447. E-mail: [email protected]
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Abstract

The present study aimed to examine the levels and interactions of family burden (FB) and expressed emotion (EE) in first episode psychosis (FEP) patients and, secondly, to observe the potential change after a brief psychoeducational group intervention implemented in a real world clinical setting. Twenty-three key relatives of FEP patients received a brief psychoeducational group intervention. FB and EE were assessed before and after the intervention. EE-change and correlations between variables were examined. Half of the sample of key-relatives showed high levels of EE. No severe family burden was observed. FB and EE did not change after the intervention. Family subjective and objective burden were correlated with emotional overinvolvement, but not with criticism. Brief psychoeducational groups may not be sufficient to reduce FB and EE associated to the experience of caregiving for a family member with a first-episode psychotic disorder.

El presente estudio tiene por objetivo examinar los niveles y las interacciones de la sobrecarga familiar (SF) y emoción expresada (EE) en cuidadores de pacientes con un primer episodio de psicosis (PEP) y, secundariamente, observar su potencial cambio después de un grupo psicoeducativo breve implementado en un contexto asistencial rutinario. Veintitrés familiares clave de pacientes con un PEP recibieron una breve intervención grupal de tipo psicoeducativo. SF y EE fueron evaluados antes y después de la intervención. Se examinó tanto el cambio de la SF y la EE como las correlaciones entre ellas. La mitad de la muestra de familiares mostró altos nivel de EE. No se observó una SF grave. Ni la SF ni la EE cambiaron después de la intervención. La sobrecarga familiar objetiva y subjetiva correlacionaron con la sobreimplicación, pero no con los comentarios críticos. Los grupos psicoeducativos breves pueden no ser suficiente para reducir la SF y la EE asociada a la experiencia

Keywords

expressed emotionburdenfirst-episode psychosispsychoeducationfamily interventionemoción expresadasobrecargaprimer episodio de psicosispsicoeducaciónintervención con familias
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 13 , Issue 1 , May 2010 , pp. 389 - 395
Copyright
Copyright © Cambridge University Press 2010

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References

Addington, J., Collins, A., McCleery, A., & Addington, D. (2005). The role of family work in early psychosis. Schizophrenia Research, 79(1), 77–83.CrossRefGoogle ScholarPubMed
Álvarez-Jiménez, M., Gleeson, J. F., Cotton, S. M., Wade, D., Crisp, K., Yap, M. B. et al. , (2010). Differential predictors of critical comments and emotional over-involvement in first-episode psychosis. Psychological Medicine, 40(1), 63–72.CrossRefGoogle ScholarPubMed
Álvarez-Jiménez, M., González-Blanch, C., Pérez-Pardal, T., Rodríguez-Sánchez, J. M., & Crespo-Facorro, B. (2007). Cognitive therapy in early psychosis and “at risk mental state”. Actas Españolas de Psiquiatría, 35(1), 67–76.Google ScholarPubMed
Askey, R., Gamble, C., & Gray, R. (2007). Family work in first-onset psychosis: a literature review. Journal of Psychiatric and Mental Health Nursing, 14(4), 356–365.CrossRefGoogle ScholarPubMed
Awad, A. G., & Voruganti, L. N. (2008). The burden of schizophrenia on caregivers: a review. Pharmacoeconomics, 26(2), 149–162.CrossRefGoogle ScholarPubMed
Birchwood, M., & Macmillan, F. (1993). Early intervention in schizophrenia. Australian and New Zealand Journal of Psychiatry, 27(3), 374–378.CrossRefGoogle ScholarPubMed
Brown, G. W., Birley, J. L., & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121(562), 241–258.CrossRefGoogle ScholarPubMed
Cañive, J. M., Sanz-Fuentenebro, J., Tuason, V. B., Vázquez, C., Schrader, R. M., Alberdi, J. et al. , (1993). Psychoeducation in Spain. Hospital and Community Psychiatry, 44(7), 679–681.Google ScholarPubMed
Crespo-Facorro, B., Pérez-Iglesias, R., Ramírez-Bonilla, M., Martínez-García, O., Llorca, J., & Vázquez-Barquero, J. L. (2006). A practical clinical trial comparing haloperidol, risperidone, and olanzapine for the acute treatment of first-episode nonaffective psychosis. Journal of Clinical Psychiatry, 67(10), 1511–1521.CrossRefGoogle ScholarPubMed
Gleeson, J., Jackson, H. J., Stavely, H., & Burnett, P. (1999). Family intervention in early psychosis. In McGorry, P. D. y Jackson, H. J. (Eds.), The recognition and management of early psychosis. A preventive approach (pp. 376–406). Cambridge: Cambridge University Press.Google Scholar
Jackson, H. J., Smith, N., & McGorry, P. (1990). Relationship between expressed emotion and family burden in psychotic disorders: an exploratory study. Acta Psychiatrica Scandinavica, 82(3), 243–249.CrossRefGoogle ScholarPubMed
Jeppesen, P., Petersen, L., Thorup, A., Abel, M. B., Oehlenschlaeger, J., Christensen, T. O. et al. , (2005). Integrated treatment of first-episode psychosis: effect of treatment on family burden: OPUS trial. British Journal of Psychiatry. Supplement, 48, s85–90.CrossRefGoogle ScholarPubMed
King, S., & Dixon, M. J. (1999). Expressed emotion and relapse in young schizophrenia outpatients. Schizophrenia Bulletin, 25(2), 377–386.CrossRefGoogle ScholarPubMed
Linszen, D., Dingemans, P., Van der Does, J. W., Nugter, A., Scholte, P., Lenior, R. et al. , (1996). Treatment, expressed emotion and relapse in recent onset schizophrenic disorders. Psychological Medicine, 26(2), 333–342.CrossRefGoogle ScholarPubMed
Martens, L., & Addington, J. (2001). The psychological well-being of family members of individuals with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 36(3), 128–133.CrossRefGoogle ScholarPubMed
Moller-Leimkuhler, A. M., & Obermeier, M. (2008). Predicting caregiver burden in first admission psychiatric patients. 2-year follow-up results. European Archives of Psychiatry and Clinical Neuroscience, 258(7), 406–413.CrossRefGoogle ScholarPubMed
Otero, V., Navascu, S. D., & Rebolledo, S. (1990). Escala de desempeño psicosocial. Adaptación española del SBAS (Social Behaviour Assessment Schedule). Psiquis, 11, 395–401.Google Scholar
Patterson, P., Birchwood, M., & Cochrane, R. (2005). Expressed emotion as an adaptation to loss: prospective study in first-episode psychosis. British Journal of Psychiatry. Supplement, 48, s59–64.CrossRefGoogle ScholarPubMed
Pharoah, F., Mari, J., Rathbone, J., & Wong, W. (2006). Family intervention for schizophrenia. Cochrane Database Systematic Reviews, 4, CD000088.Google Scholar
Platt, S., Weyman, A., Hirsch, S., & Hewett, S. (1980). The Social Behaviour Assessment Schedule (SBAS): Rationale, Contents, Scoring and Reliability of a New Interview Schedule. Social Psychiatry, 15, 43–55.CrossRefGoogle Scholar
Raj, L., Kulhara, P., & Avasthi, A. (1991). Social burden of positive and negative schizophrenia. International Journal of Social Psychiatry, 37(4), 242–250.CrossRefGoogle ScholarPubMed
Raune, D., Kuipers, E., & Bebbington, P. E. (2004). Expressed emotion at first-episode psychosis: investigating a carer appraisal model. British Journal of Psychiatry, 184, 321–326.CrossRefGoogle ScholarPubMed
Santos, A., Espina, A., Pumar, B., Gonzalez, P., Ayerbe, A., & Garcia, E. (2001). Longitudinal study of the stability of expressed emotion in families of schizophrenic patients: a 9-month follow-up. The Spanish Journal of Psychology, 4(1), 65–71.CrossRefGoogle ScholarPubMed
Scazufca, M., & Kuipers, E. (1996). Links between expressed emotion and burden of care in relatives of patients with schizophrenia. British Journal of Psychiatry, 168(5), 580–587.CrossRefGoogle ScholarPubMed
Scazufca, M., & Kuipers, E. (1998). Stability of expressed emotion in relatives of those with schizophrenia and its relationship with burden of care and perception of patients' social functioning. Psychological Medicine, 28(2), 453–461.CrossRefGoogle ScholarPubMed
Smith, J., Birchwood, M., Cochrane, R., & George, S. (1993). The needs of high and low expressed emotion families: a normative approach. Social Psychiatry and Psychiatric Epidemiology, 28(1), 11–16.CrossRefGoogle ScholarPubMed
Szmukler, G., Kuipers, E., Joyce, J., Harris, T., Leese, M., Maphosa, W. et al. , (2003). An exploratory randomised controlled trial of a support programme for carers of patients with a psychosis. Social Psychiatry and Psychiatric Epidemiology, 38(8), 411–418.CrossRefGoogle ScholarPubMed
Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20(5), 633–666.CrossRefGoogle ScholarPubMed
Wiedemann, G., Rayki, O., Feinstein, E., & Hahlweg, K. (2002). The Family Questionnaire: development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Research, 109(3), 265–279.CrossRefGoogle ScholarPubMed