Principles and results of family therapy in schizophrenia

There is growing evidence that social factors contribute significantly to t he course and outcome in schizophrenia. In particular, the relationship bet ween high EE and schizophrenic relapse has been documented by many investig ators. Since 1980, several psychoeducational family management programs hav e been evaluated showing a significant reduction in relapse when compared t o standard psychiatric care. To prevent tardive dyskinesia, alternative med ication strategies have been introduced, e. g. low dose and targeted medica tion. In the Munich treatment study the combined effects of behavioral fami ly management (BFM) and standard dose (SD) or targeted neuroleptic medicati on TM) on relapse and social functioning of the patient as well as coping a nd burden of the family have been investigated. N = 51 patients with 73 rel atives were randomly assigned to the two groups (BFMSD = 27, BFMTM = 24). R elapse rates at 18 month were: BFSD = 3.9%, BFMTM = 33.8%. In summary, psyc hoeducational family management in combination with standard dose medicatio n proved to be highly effective in preventing relapse in schizophrenia. The se results are in line with findings of anglo-american studies and call for a more widespread application of these new psychosocial approaches in orde r to provide the best services available for the chronically ill schizophre nic patient and their families.