A Cochrane review [Abstract] 1 included 7 studies with a total of 393 subjects. All of the included studies assessed psychoeducational methods, and one study also assessed a type of systems psychotherapy. In all trials, participants continued to receive pharmacotherapy treatment. Due to the diversity of interventions, outcome measures and endpoints used, it was not possible to perform meta-analyses for primary outcomes. Five studies compared a variety of family interventions, involving carers, families or spouses, against no intervention, with individual findings indicating no significant added effect for family interventions. Three studies compared one type or modality of family intervention against another family intervention, with inconsistent findings. There was no significant difference in recovery rates between groups at 28 months' post-treatment for all patients (62 participants, RR 0.87, 95% CI 0.52 to 1.47) or for manic patients only (45 participants, RR 0.82, 95% CI 0.43 to 1.55). There was no significant difference in clinical improvement rates between groups at post-treatment (26 participants, RR 0.49, 0.10 to 2.45) or at 6 months follow-up (RR 0.73, 95% CI 0.05 to 10.49). Similarly, there was no significant difference in SCL-90 total symptoms between groups at 12 months' post treatment (39 participants, RR 0.03, 95% CI -0.59 to 0.66). No studies provided data on relapse rates.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes), by imprecise results (few patients and wide confidence intervals) and by study quality (inadequate or unclear allocation concealment).
Primary/Secondary Keywords