Changes in patient coping style following individual and family treatment for schizophrenia

Article Abstract:

Expressed emotion (EE) measures the quality of relationships within families and evaluates family members' critical and hostile feelings towards each other. High-EE ratings among family members have been shown to lead to high relapse rates for schizophrenic patients. To assess ways in which changes in EE and subsequent changes in the interactional coping style (CS) of patients affect relapse rates, 33 schizophrenic patients of mixed ethnic backgrounds (aged 18 to 41 years) were studied. At intake and after three months of treatment, CS was measured by a CS scale sensitive to different ways patients behave with high- and low-EE family members. Fifteen patients were assigned to individual treatment consisting of supportive psychotherapy, case management, education about schizophrenia, and crisis intervention. The others were placed in behavioral family therapy with a focus on home-based problem-solving, education and communication-skills training. Therapy consisted of weekly sessions for three months and biweekly sessions for the next six months. Patients were followed-up for two years and clinical symptoms were assessed monthly. Data analysis did not demonstrate a consistent relationship between CS, relapse and clinical symptoms. The quality of CS before or after treatment did not predict relapse in either treatment group. Both groups demonstrated a systematic but statistically non-significant trend towards improved CS at three months. Future research is needed to assess changes in CS over the latter course of the illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Behavior, Family, Psychiatric hospital patients

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A trial of family therapy versus a relative's group for schizophrenia: two-year follow-up

Article Abstract:

Two-year follow-up assessments were made of two types of family therapy for schizophrenic outpatients maintained on neuroleptic (antipsychotic) medication. Twelve families received family therapy in their homes, which included the patient's participation. Eleven families attended group therapy in which the patient was excluded. At the onset of the study, patients in both groups were similar in terms of demographics, and displayed similar psychiatric symptoms (i.e., delusions and hallucinations). Family members were also well matched in terms of ratings of expressed emotion (EE). EE is a measure of the quality of relationships within families: high EE indicates more hostility and a more critical attitude toward the patient. At a nine-month follow up, significant reductions in EE ratings were found in both groups, These ratings stabilized and did not show further decline at the two-year follow-up. Eight patients who had blunted emotions at the onset of the study showed significant improvement after two-years. Seven of them lived in homes in which EE rates were reduced. There were no significant differences found in relapse rates between groups: 33 percent of the patients in the family therapy group and 36 percent in the relatives' group relapsed, and reverted to psychotic behavior. In an earlier study, the relapse rate for patients who received no social intervention was found to be 76 percent. Comparison of relapse rates makes it appear that both types of family interventions are beneficial. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Cognitive functioning and its relationship to symptoms and social functioning in schizophrenia

Article Abstract:

There are two primary domains in the study of schizophrenia: those working within a cognitive framework and those looking at the disease from a social perspective. Unfortunately, the two areas do not share their experiences with each other nor do they generally try to integrate their findings. Cognitive theorists target the disordered thinking processes, while those taking a social approach place more importance upon stress factors and other social influences in the disease. Using a word-association test, 19 schizophrenic patients were assessed in an effort to find a link between contextual processing (a cognitive factor), social functioning, and symptoms. Variables were social competence assessed via sociodemographic information, symptom status or severity, and cognitive status as measured by performance on memory tasks. It was found that decreased occupational status was correlated with an increased number of symptoms, more severe symptoms, and a younger age of onset of schizophrenia. It was also found that contextual processing on the word association test was related to current symptom status and employment history. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Cognition disorders, Cognitive disorders

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