Effectiveness of targeted intervention and maintenance pharmacotherapy in conjunction with family intervention in schizophrenia

A sample of 85 patients with schizophrenia, of whom 34 later dropped out, r eceived randomised treatment. There were no significant differences between treatment-takers and drop-outs in the variables assessed, patients receive d either standard-dose maintenance neuroleptic treatment or targeted mainte nance pharmacotherapy and all patients received behavioural family therapy. Measures of psychopathology, social adjustment, side-effects, family burde n, and expressed emotion were assessed at baseline and then periodically ov er an 18-month period. The study was designed to compare the two alternativ e pharmacological maintenance approaches, each of them supported by psychos ocial intervention. Any evaluation of the impact of behavioural family trea tment on relapse rates and other outcome criteria is exclusively descriptiv e. A significantly higher rate of relapse was observed at 18 months in pati ents randomised to targeted treatment compared to those randomised to stand ard-dose treatment (35 % vs 4 %). Although patients assigned to the targete d maintenance group received significantly lower mean doses of neuroleptics , there were no significant differences between the two groups with regard to side-effects, global measures of social function, and overall psychopath ology. Family burden was higher in the targeted-treatment group at six mont hs, but did not differ at the one-year and eighteen-month time points. Howe ver, both groups improved significantly from baseline to 12 or 18 months in almost all variables assessed. Thus, the behavioural family approach did n ot compensate for the problems associated with the targeted medication stra tegy.