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Evidence summaries

Psychoeducation (Brief) for People with Schizophrenia

Brief psychoeducation of any form may reduce relapses in the medium term, and promote medication compliance in the short term in schizophrenia. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 20 studies with a total of 2337 participants with schizophrenia. Nineteen studies compared brief psychoeducation with routine care or conventional delivery of information. One study compared brief psychoeducation with cognitive behavior therapy.Participants receiving brief psychoeducation were less likely to be non-compliant with medication than those receiving routine care in the short term (up to 12 weeks: RR 0.63, CI 0.41 to 0.96; 3 RCTs, n = 448) and medium term (12-52 weeks: RR 0.17, CI 0.05 to 0.54; 1 RCT, n = 118).Compliance with follow-up was similar between the two groups in the short term (RR 1.00, CI 0.24 to 4.18; 1 RCT, n = 30), medium term (RR 0.74, CI 0.50 to 1.09; 4 RCTs, n = 322) and long term (over 52 weeks: RR 1.19, CI 0.83 to 1.72; 2 RCTs, n = 386).Relapse rates were significantly lower amongst participants receiving brief psychoeducation than those receiving routine care in the medium term (RR 0.70, CI 0.52 to 0.93; n = 406), but not in the long term.Data from a few individual studies supported that brief psychoeducation: i) can improve the long-term global state (MD -6.70, CI -13.38 to -0.02; 1 RCT, n = 59); ii) promote improved mental state in short term (MD -2.70, CI -4.84 to -0.56; 1 RCT, n = 60) and medium term; iii) can lower the incidence and severity of anxiety and depression.Social function such as rehabilitation status (MD -13.68, CI -14.85 to -12.51; 1 RCT, n = 118) and social disability (MD -1.6, CI -2.09 to -1.83; 1 RCT, n = 118) were also improved in the brief psychoeducation group. There was no difference found in quality of life as measured by GQOLI-74 in the short term (MD 0.63, CI -0.79 to 2.05; 1 RCT, n = 62), nor the death rate in either groups (RR 0.99, CI 0.15 to 6.65; 2 RCTs, n = 154).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment) and indirectness (short follow-up time) but upgraded by consistent findings.

References

  • Zhao S, Sampson S, Xia J et al. Psychoeducation (brief) for people with serious mental illness. Cochrane Database Syst Rev 2015;4():CD010823. [PubMed].

Primary/Secondary Keywords