MULTIPLE-FAMILY GROUPS AND PSYCHOEDUCATION IN THE TREATMENT OF SCHIZOPHRENIA

Objective: To compare outcomes in psychoeducational multiple-family gr oup treatment vs psychoeducational single-family treatment. Method: A total of 172 acutely psychotic patients, aged 18 to 45 years, with DSM -III-R schizophrenic disorders were randomly assigned to single- or mu ltiple-family psychoeducational treatment at six public hospitals in t he state of New York. Psychotic relapse, symptom status, medication co mpliance, rehospitalization, and employment were assessed independentl y during 2 years of supervised treatment. Results: The multiple-family groups yielded significantly lower 2-year cumulative relapse rates th an did the single-family modality (16% vs 27%) and achieved markedly l ower rates in patients whose conditions had not remitted at index hosp ital discharge (13% vs 33%). The relapse hazard ratio between treatmen ts was 1:3. The relapse rate for both modalities was less than half th e expected rate (65% to 80% for 2 years) for patients receiving indivi dual treatment and medication. Rehospitalization rates and psychotic s ymptoms decreased significantly, and medication compliance was high, t o an equal degree in both modalities. Conclusion: Psychoeducational mu ltiple-family groups were more effective than single-family treatment in extending remission, especially in patients at higher risk for rela pse, with a cost-benefit ratio of up to 1:34.