Family Psychoeducation Reduces Relapse in Major Depression

Peter Roy-Byrne, MD


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Abstract and Introduction


Patients whose families received information and problem-solving education to reduce stressful family interactions had lower relapse rates at 9 months.


Although most psychiatric treatment guidelines recommend educating and intervening with families, there has been limited empirical study on the effectiveness of this commonly used intervention component, except in patients with schizophrenia or bipolar disorder. Researchers in Japan conducted a small, randomized, controlled study of family psychoeducation's effect in 57 adults (mean age, 60) with major depression, who had responded partially or fully (mean score on the Hamilton Rating Scale for Depression, 13.6) to acute-phase antidepressant treatment and were in the continuation/maintenance phase of treatment.

All patients were receiving medication and supportive psychotherapy. In the intervention arm, the primary family member received small-group psychoeducation, which consisted of four biweekly educational and discussion sessions on the nature of depression, its treatment, and problem-solving strategies to minimize patient stress in situations involving high "expressed emotion" (EE). By the 9-month follow-up, the intervention was associated with significantly longer time to relapse than the control approach and a lower relapse rate (8% vs. 50%). EE scores did not change from baseline to 9 months. In the intervention arm, outcomes were similar in patients from families with high and low baseline EE scores.


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