A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients
Abstract
Summary: A study is reported of a controlled trial of social intervention in the families of schizophrenic patients at high risk of relapse. The patients were selected for being in high contact with high Expressed Emotion relatives. All patients were maintained on neuroleptic drugs. One half of the 24 families were randomly assigned to routine out-patient care, while the other half received a package of social interventions. This comprised a programme of education about schizophrenia, a group for the relatives, and family sessions for relatives and patients. The relapse rate in the control group was 50 per cent compared with nine per cent in the experimental group (P = 0.04). The stated aims of the therapeutic interventions were achieved in 73 per cent of experimental families. In these families, no patient relapsed. The results provide evidence for the causal role of relatives' expressed emotion (EE) in schizophrenic relapse, as well as for the therapeutic effectiveness of social intervention combined with drug treatment.
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People whose supporters received training tend to have fewer relapses than others.
“People whose supporters received training tend to have fewer relapses than others 323 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [323]
Cites
Book Review: Measurement and Classification of Psychiatric Symptoms
Priest, R. G. (1975) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591577506800751 · Cited by 2,268 · see citing works
Measurement and classification of psychiatric symptoms
Goldberg, D. (1975) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(75)90076-8 · Cited by 2,201 · see citing works
Influence of Family Life on the Course of Schizophrenic Disorders: A Replication
Brown, G. W., Birley, J. L. T., & Wing, J. K. (1972) · British Journal of Psychiatry · doi:10.1192/bjp.121.3.241 · Cited by 1,770 · see citing works
The Influence of Family and Social Factors on the Course of Psychiatric Illness
Vaughn, C. E., & Leff, J. (1976) · The British Journal of Psychiatry · doi:10.1192/bjp.129.2.125 · Cited by 1,665 · see citing works
Self-citationThe Measurement of Expressed Emotion in the Families of Psychiatric Patients
Vaughn, C. E., & Leff, J. (1976) · British Journal of Social and Clinical Psychology · doi:10.1111/j.2044-8260.1976.tb00021.x · Cited by 1,039 · see citing works
Self-citationCrises and Life Changes and the Onset of Schizophrenia
Brown, G. W., & Birley, J. L. T. (1968) · Journal of Health and Social Behavior · doi:10.2307/2948405 · Cited by 680 · see citing works
Influence of Family Life on the Course of Schizophrenic Illness
Brown, G. W., Monck, E., CARSTAIRS, G. M., & Wing, J. K. (1962) · Journal of Epidemiology & Community Health · doi:10.1136/jech.16.2.55 · Cited by 578 · see citing works
Drug and Sociotherapy in the Aftercare of Schizophrenic Patients
Hogarty, G. E. (1974) · Archives of General Psychiatry · doi:10.1001/archpsyc.1974.01760170005001 · Cited by 573 · see citing works
Drug and Family Therapy in the Aftercare of Acute Schizophrenics
Goldstein, M. J. (1978) · Archives of General Psychiatry · doi:10.1001/archpsyc.1978.01770340019001 · Cited by 521 · see citing works
Fluphenazine and Social Therapy in the Aftercare of Schizophrenic Patients
Hogarty, G. E. (1979) · Archives of General Psychiatry · doi:10.1001/archpsyc.1979.01780120013001 · Cited by 365 · see citing works
Trial of Maintenance Therapy in Schizophrenia
Leff, J., & Wing, J. K. (1971) · BMJ · doi:10.1136/bmj.3.5775.599 · Cited by 339 · see citing works
Self-citationDrug and Sociotherapy in the Aftercare of Schizophrenic Patients
Hogarty, G. E. (1973) · Archives of General Psychiatry · doi:10.1001/archpsyc.1973.01750310038007 · Cited by 283 · see citing works
Leff, J., & Vaughn, C. E. (1981) · The British Journal of Psychiatry · doi:10.1192/bjp.139.2.102 · Cited by 261 · see citing works
Self-citationBodily Reactions to People and Events in Schizophrenics
Tarrier, N. (1979) · Archives of General Psychiatry · doi:10.1001/archpsyc.1979.01780030077007 · Cited by 182 · see citing works
New developments in interventions with families of schizophrenics
Goldstein, M. J. (1981) · Jossey-Bass eBooks · Cited by 142 · see citing works
ABNORMALITIES IN PARENTS OF SCHIZOPHRENICS
Forrest, A. D. (1976) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.39.9.927-c · Cited by 132 · see citing works
Schizophrenia and Sensitivity to the Family Environment
Leff, J. (1976) · Schizophrenia Bulletin · doi:10.1093/schbul/2.4.566 · Cited by 109 · see citing works
Self-citationPsychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives
Sturgeon, D., Kuipers, L., Berkowitz, R., Turpin, G., & Leff, J. (1981) · The British Journal of Psychiatry · doi:10.1192/bjp.138.1.40 · Cited by 84 · see citing works
Self-citationCommunity Care for the Mentally Disabled
Platman, S. R. (1980) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198008000-00021 · Cited by 73 · see citing works
Lowering expressed emotion in relatives of schizophrenics
Berkowitz, R., Kuipers, L., Eberlein-Fries, R., & Leff, J. (1981) · New Directions for Mental Health Services · doi:10.1002/yd.23319811204 · Cited by 62 · see citing works
Self-citationAbnormalities in parents of schizophrenics
Forrest, A. (1976) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(76)90069-6 · Cited by 51 · see citing works
Community care for the mentally disabled
Wing, J. K., & Olsen, R. S. (1979) · Medical Entomology and Zoology · Cited by 41 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Expressed Emotion and Psychiatric Relapse: A Meta-analysis
Butzlaff, R. L., & Hooley, J. M. (1998) · Archives of General Psychiatry · doi:10.1001/archpsyc.55.6.547 · Cited by 1,310 · see citing works
Mental health stigma as social attribution: Implications for research methods and attitude change.
Corrigan, P. W. (2000) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.7.1.48 · Cited by 954 · see citing works
PILLING, S., BEBBINGTON, P., KUIPERS, E., GARETY, P., GEDDES, J., ORBACH, G., & MORGAN, C. (2002) · Psychological Medicine · doi:10.1017/s0033291702005895 · Cited by 887 · see citing works
Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder
Frank, E., Kupfer, D. J., Thase, M. E., Mallinger, A. G., Swartz, H. A., Fagiolini, A. M., Grochocinski, V., Houck, P., Scott, J., Thompson, W., et al. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.9.996 · Cited by 770 · see citing works
Baucom, D. H., Shoham, V., Mueser, K. T., Daiuto, A. D., & Stickle, T. R. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.1.53 · Cited by 608 · see citing works
Levels of expressed emotion and relapse in depressed patients
Hooley, J. M., Orley, J., & Teasdale, J. D. (1986) · British Journal of Psychiatry · doi:10.1192/bjp.148.6.642 · Cited by 499 · see citing works
Expressed Emotion and Relapse of Psychopathology
Hooley, J. M. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.2.022305.095236 · Cited by 499 · see citing works
The stress cascade and schizophrenia: Etiology and onset
Corcoran, C., Walker, E., Huot, R., Mittal, V., Tessner, K., Kestler, L., & Malaspina, D. (2003) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a007038 · Cited by 439 · see citing works
Cognitive model of caregiving in psychosis
Kuipers, E., Onwumere, J., & Bebbington, P. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.070466 · Cited by 225 · see citing works
Expressed emotion: A review of the critical literature
Hooley, J. M. (1985) · Clinical Psychology Review · doi:10.1016/0272-7358(85)90018-2 · Cited by 229 · see citing works
Chen, F.-P., & Greenberg, J. S. (2004) · Community Mental Health Journal · doi:10.1023/b:comh.0000040656.89143.82 · Cited by 173 · see citing works
The effects of family interventions on relatives’ burden: a meta-analysis
PIM, C. (1999) · Journal of Mental Health · doi:10.1080/09638239917436 · Cited by 158 · see citing works
Psychosocial Treatments in Schizophrenia: A Review of the Past 20 Years
HUXLEY, N. A., RENDALL, M., & SEDERER, L. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200004000-00001 · Cited by 152 · see citing works
Why involve families in acute mental healthcare? A collaborative conceptual review
Dirik, A., Sandhu, S., Giacco, D., Barrett, K., Bennison, G., Collinson, S., & Priebe, S. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-017680 · Cited by 95 · see citing works
Askey, R., Holmshaw, J., Gamble, C., & Gray, R. (2009) · Journal of Family Therapy · doi:10.1111/j.1467-6427.2009.00470.x · Cited by 89 · see citing works
Galderisi, S., Appelbaum, P. S., Gill, N., Gooding, P., Herrman, H., Melillo, A., Myrick, K., Pathare, S., Savage, M., Szmukler, G., et al. (2024) · World Psychiatry · doi:10.1002/wps.21230 · Cited by 76 · see citing works
Relatives as a Resource in the Management of Functional Illness
Kuipers, L., & Bebbington, P. (1985) · British Journal of Psychiatry · doi:10.1192/bjp.147.5.465 · Cited by 44 · see citing works
Self-citationWiedemann, G., Hahlweg, K., Müller, U., Feinstein, E., Hank, G., & Dose, M. (2001) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s004060170056 · Cited by 23 · see citing works
- Authors
- Leff, J., Kuipers, L., Berkowitz, R., Eberlein-Vries, R., & Sturgeon, D.
- Affiliations
- University College London (GB)
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 1982-08
- Volume
- 141
- Issue
- 2
- Pages
- 121-134
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2152563445
- Cited by
- 869
- References
- 22
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 36 · 2020: 4 · 2019: 6 · 2018: 22 · 2017: 6 · 2016: 5 · 2015: 7 · 2014: 12 · 2013: 6 · 2012: 10
- FWCI
- 46.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- schizophrenia, relapse prevention, expressed emotion, family intervention, social intervention, relatives of schizophrenic patients, family education, outpatient care, relapse rate
- MeSH terms
- Adult, Emotions, Family Therapy, Female, Humans, Interpersonal Relations, Male, Middle Aged, Recurrence, Schizophrenia
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