Friday, April 10, 2015

Effectiveness of brief psychoeducation (10 sessions or less) for people with serious mental illness

Cochrane: To investigate the effectiveness of brief psychoeducation compared with standard care as a means of helping people with serious mental illness. To investigate whether any kind (individual/ family/group) of brief psychoeducation is better than others.

Schizophrenia is a serious, long-term mental illness where people experience hallucinations and/or delusions and are often unable to distinguish these experiences from reality. Hearing voices and seeing things can be disturbing, confusing and frightening and can lead to changes in behaviour. It is suggested that insight into the illness can help people to understand the need for treatment and subsequently improve the prognosis.
However, the nature of schizophrenia is such that it alters peoples thought processes and they are often unable to have insight into their illness. The stigma of having a mental illness can also influence a person's willingness to seek or take treatments. Effective education of people with schizophrenia can improve insight and understanding. Psychoeducation programmes have been developed, specifically aimed at people with mental health problems. It is not simply providing information to patients. Rather, it is a form of empowering training targeted at promoting awareness and providing tools to manage, cope and live with a mental illness. However, psychoeducation can be time consuming; brief psychoeducation has been developed as a possible solution to this problem. In this review the authors defined brief psychoeducation to be a psychoeducation programme of 10 sessions or less.

Study characteristics.
The review authors searched for randomised trials in 2013 and found 20 relevant studies with 2337 participants. Half of the studies were carried out in China. These trials randomised people to receive either brief psychoeducation sessions (these ranged from one-day psychoeducation to eight sessions of psychoeducation over a period of one year) or routine care.

Key results.
Based on information from a limited number of studies, brief psychoeducation does seem to reduce relapse and encourage people to take their medication. Those receiving brief psychoeducation also have more favourable results for mental state and social functioning.

Quality of the evidence.
Although initial results are encouraging, most information and data for the main outcomes of interest, were rated as low or very low quality, and the number of trials providing useful data is small. Until further large, high-quality studies become available, the usefulness of brief psychoeducation remains debatable.
Ben Gray, Senior Peer Researcher, McPin Foundation.
Authors' conclusions: 
Based on mainly low to very low quality evidence from a limited number of studies, brief psychoeducation of any form appears to reduce relapse in the medium term, and promote medication compliance in the short term. A brief psychoeducational approach could potentially be effective, but further large, high-quality studies are needed to either confirm or refute the use of this approach.