Academic journal article Hong Kong Journal of Psychiatry

Group Psychosocial Education for Relatives of Schizophrenic Patients in Community: A Three-Year Experience

Academic journal article Hong Kong Journal of Psychiatry

Group Psychosocial Education for Relatives of Schizophrenic Patients in Community: A Three-Year Experience

Article excerpt

SUMMARY

A prospective three-year control study was canned out in Nanshi district of Shanghai, People's Republic of China, It aimed to assess the long-term effectiveness of group psychosocial education program for relatives of schizophrenic patients in the community. The experimental group consisted of relatives of 251 patients. They were given a psycho-social education program which included 16 lectures on mental illness and 7 group discussions. The control group consisted of relative of 158 patients. At the end of the third year, patients in the experimental group had lower relapse rate, higher rate of regular work and better social functioning than those in control group. While the relatives in the experimental group had less care burden; had more knowledge about schizophrenia and it% treatment, and had relatively better mental and physical status. The educational approach were well accepted by both relatives and mental health workers. It is concluded that more attention should be paid on psychosocial intervention in community-based psychiatric rehabilitation.

Key words: schizophrenia, community service, family intervention, psychosocial education, group therapy, Chinese

INTRODUCTION

Schizophrenia is a chronic psychiatric disorder with long illness duration and high relapse rate. It often resulted in impairment on psychosocial functioning. The development of modern psycho-pharmacology has significantly improved the patients' prognosis; has shortened the duration of hospital stay; and has made more discharges of patients hack to the community. Many of these schizophrenic patients were therefore be taken care of by their relatives in the community. However, this has created new challenges to these relatives. Questions on methods of rehabilitating patients in the community, reducing their relapse rate and methods to reduce the care burden and to avoid psychosomatic impairment on family members were often raised.

In the last ten years, many researches have focused on interventions with families of schizophrenic patients. Particularly, the researches on expressed emotion (Brown, 1997; Leff, 1952; Vaughn, 1976) have revealed that high levels of expressed emotion can often precipitate relapses. Family intervention measures have therefore been developed with the hope to reduce the levels of expressed emotion in the families of these patients, Such individual family treatment and intervention required the skills of specially trained therapists. But in the developing country like the People's Republic of China, they obviously have difficult to be applied them widely because of the shortage of specialists as comparing to the huge patient volume.

We have developed a 3-years group psychosocial education program for the relatives of schizophrenics in Nanshi district of Shanghai. The results of first-year and second-year were positive in improving effectiveness of both schizophrenic patients and their family members (Zhang, 1993), The present paper described the results of the three-year follow up of these patients and their relatives after completing the education program.

METHODOLOGY

SAMPLE

By random cluster sampling method, a probability sample of patients was drawn from the community patient registration centers. The criteria for enroll-ment into the study were. (1) diagnosed as suffering from schizophrenia basing upon the Chinese Classif-ication and Diagnostic Criteria of Mental Disorders (CCMD-2), which is similar to LCD-10 and DSM-IV; (2) aged between 16 to 59; and (3) living with at least one relative who could participate in the group education program. All patients in the probability sample who met enrolment criteria were randomly divided into two groups: experimental group and control group according to the ratio 2:1. Families in experimental group were given the psychosocial education program in addition to the routine community mental health services while the control group received routine services only. …

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