A Cochrane review [Abstract] 1 included 53 RCTs. All participants received family interventions and some had an educational component. The control groups were all given standard care that involved pharmacological interventions. Family intervention may decrease the frequency of relapse (RR 0.55, CI 0.5 to 0.6, NNT 7, CI 6 to 8; 32 RCTs, n = 2981). Family intervention may also reduce hospital admission (RR 0.78, 95% CI 0.6 to 1.0, NNT 8, 95% CI 6 to 13; 8 RCTs, n=481). Family intervention may also encourage compliance with medication (RR 0.60, CI 0.5 to 0.7, NNT 6, CI 5 to 9; 10 RCTs, n = 695) but does not obviously affect the tendency of individuals/families to leave the care (RR 0.74, CI 0.5 to 1.0; 10 RCTs, n = 733). It may improve general social impairment and the levels of expressed emotion within the family. No data was found to suggest that family intervention either prevents or promotes suicide.
Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment) and inconsistency (heterogeneity in patients and interventions).
Primary/Secondary Keywords