Family psychoeducation for major depression: randomised controlled trial
Open accessAbstract
Background: The value of family psychoeducation for schizophrenia has been well established, and indications for its use have recently expanded to include bipolar affective disorder. However, no study to date has adequately examined its use in depression. Aims: To examine family psychoeducation in the maintenance treatment of depression and to investigate the influence of the family's expressed emotion (EE) on its effectiveness. Method: Of 103 patients diagnosed with major depression and their primary family members, 57 pairs provided written informed consent. The pairs were randomly allocated to the intervention (n = 25) or control (n = 32). One family in the intervention group and two in the control group withdrew their consent after randomisation. The intervention group underwent four psychoeducation sessions consisting of didactic lectures about depression and group problem-solving focusing on how to cope in high-EE situations. Patients did not attend these sessions. Patients in both the intervention and control groups received treatment as usual. The families' EE levels were evaluated through Five-Minute Speech Samples. The primary outcome was relapse. Results: Time to relapse was statistically significantly longer in the psychoeducation group than in the control group (Kaplan–Meier survival analysis, P = 0.002). The relapse rates up to the 9-month follow-up were 8% and 50% respectively (risk ratio 0.17, 95% CI 0.04–0.66; number needed to treat 2.4, 95% CI 1.6–4.9). In Cox proportional hazard analysis, baseline EE did not moderate the effectiveness of the intervention. Conclusions: Family psychoeducation is effective in the prevention of relapse in adult patients with major depression.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Family psychoeducation continued for up to 10 months reduced recurrence risks in patients with major depressive disorder (clinically effective).
“Among these, notably, family psychoeducation continued for up to 10 months was examined in two Japanese studies and found to be clinically effective and cost-effective in reducing recurrence risks in major depressive disorder patients (Shimazu et al., 2011; Shimodera et al., 2012).”
From Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials (2016) · cites this paper as Shimazu et al., 2011
The Discussion reports that four sessions of family psychoeducation significantly reduced relapse compared with treatment as usual, supporting clinical effectiveness. But the Family psychoeducation section says sessions occurred every two weeks, and the Discussion reports outcomes for up to 9 months; the intervention did not continue for up to 10 months. (LLM, conf=0.90)
Experimental — accuracy not yet measuredFamily psychoeducation continued for up to 10 months was cost-effective.
“Among these, notably, family psychoeducation continued for up to 10 months was examined in two Japanese studies and found to be clinically effective and cost-effective in reducing recurrence risks in major depressive disorder patients (Shimazu et al., 2011; Shimodera et al., 2012).”
From Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials (2016) · cites this paper as Shimazu et al., 2011
The Discussion reports that four sessions of family psychoeducation reduced relapse for up to 9 months, supporting clinical effectiveness. The Family psychoeducation section describes four sessions held every two weeks, not an intervention continued for up to 10 months. No cost-effectiveness finding appears in the passages retrieved by searches for cost and economic terms. (LLM, conf=0.88)
Experimental — accuracy not yet measuredFamily psychoeducation appeared to be useful long-term in two studies reported from Japan.
“Family psychoeducation appeared to be useful long-term in two studies reported from Japan (Shimazu et al., 2011; Shimodera et al., 2012).”
From Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials (2016) · cites this paper as Shimazu et al., 2011
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Remission and relapse in major depression: a two-year prospective follow-up study
Ramana, R., Paykel, E. S., Cooper, Z., Hayhurst, H., Saxty, M., & Surtees, P. G. (1995) · Psychological Medicine · doi:10.1017/s0033291700033134 · Cited by 236 · see citing works
Flagged first, then by citations
Research works printed but not linked: 29
- Bebbington P, Kuipers L. The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychol Med 1994; 24: 707-18.
- Falloon IR, Boyd JL, McGill CW, Razani J, Moss HB, Gilderman AM. Family management in the prevention of exacerbation of schizophrenia: a controlled study. New Engl J Med 1982; 306: 1437-40.
- Leff J, Kuipers L, Berkowitz R, Eberlein-Vries R, Sturgeon D. A controlled trial of social intervention in the families of schizophrenic patients. Br J Psychiatry 1982; 141: 121-34.
- Shimodera S, Inoue S, Mino Y, Tanaka S, Kii M, Motoki Y. Expressed emotion and psychoeducational intervention for relatives of patients with schizophrenia: a randomized controlled study in Japan. Psychiatry Res 2000; 96: 141-8.
- Miklowitz D, Goldstein MJ, Nuechterlein KH, Snyder KS, Mintz J. Family factors and the course of bipolar affective disorder. Arch Gen Psychiatry 1988; 45: 225-31.
- Kim EY, Miklowitz DJ. Expressed emotion as predictor of outcome among bipolar patients undergoing family therapy. J Affect Disord 2004; 82: 343-52.
- Reinares M, Colom F, Sanchez-Moreno J, Torrent C, Martinez-Aran A, Comes M, et al. Impact of caregiver group psychoeducation on the course and outcome of bipolar patients in remission: a randomized controlled trial. Bipolar Disord 2008; 10: 511-9.
- Miklowitz DJ, George EL, Richards JA, Simoneau TL, Suddath RL. A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Arch Gen Psychiatry 2003; 60: 904-12.
- Rea MM, Tompson MC, Miklowitz DJ, Goldstein MJ, Hwang S, Mintz J. Family-focused treatment versus individual treatment for bipolar disorder: results of a randomized clinical trial. J Consult Clin Psychol 2003; 71: 482-92.
- Vaughn CE, Leff JP. The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. Br J Psychiatry 1976; 129: 125-37.
- Hooley JM, Orley J, Teasdale JD. Levels of expressed emotion and relapse in depressive patients. Br J Psychiatry 1986; 148: 642-7.
- Priebe S, Wildgrube C, Mu ¨ller-Oerlinghausen B. Lithium prophylaxis and expressed emotion. Br J Psychiatry 1989; 154: 396-9.
- Okasha A, El Akabawi AS, Snyder KS, Wilson AK, Youssef I, el Dawla AS. Expressed emotion, perceived criticism, and relapse in depression: a replication in an Egyptian community. Am J Psychiatry 1994; 151: 1001-5.
- Hayhurst H, Cooper Z, Paykel ES, Vearnals S, Ramana R. Expressed emotion and depression. A longitudinal study. Br J Psychiatry 1997; 171: 439-43.
- Mino Y, Shimodera S, Inoue S, Fujita H, Tanaka S, Kanazawa S. Expressed emotion of families and the course of mood disorders: a cohort study in Japan. J Affect Disord 2001; 63: 43-9.
- Kessler RC, Demler O, Frank RG, Olfson M, Pincus HA, Walters EE, et al. Prevalence and treatment of mental disorders, 1990 to 2003. New Engl J Med 2005; 16: 2515-23.
- Kanai T, Takeuchi, H, Furukawa, TA, Yoshimura R, Imaizumi T, Kitamura T, et al. Time to recurrence after recovery from major depressive episodes and its predictors. Psychol Med 2003; 33: 839-45.
- Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry 2003; 64: 1465-75.
- Folstein MF, Folstein SE, McHugh PR. 'Mini-mental state': a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-98.
- Magan ˜a AB, Goldstein JM, Karno M, Miklowitz DJ, Jenkins J, Falloon IR. A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Res 1986; 17: 203-12.
- Shimodera S, Mino Y, Inoue S, Izumoto Y, Kishi Y, Tanaka S. Validity of a Five- Minute Speech Sample in measuring expressed emotion in the families of patients with schizophrenia in Japan. Compr Psychiatry 1999; 40: 372-6.
- Kavanagh DJ, O'Halloran P, Manicavasagar V, Clark D, Piatkowska O, Tennant C, et al. The Family Attitude Scale: reliability and validity of a new scale for measuring the emotional climate of families. Psychiatry Res 1997; 70: 185-95.
- Fujita H, Shimodera S, Izumoto Y, Tanaka S, Kii M, Mino Y, et al. Family attitude scale: measurement of criticism in the relatives of patients with schizophrenia in Japan. Psychiatry Res 2002; 31: 273-80.
- Shimodera S, Mino Y, Fujita H, Izumoto Y, Kamimura N, Inoue S. Validity of a five-minute speech sample for the measurement of expressed emotion in the families of Japanese patients with mood disorders. Psychiatry Res 2002; 112: 231-7.
- Uehara T, Yokoyama T, Goto M, Ihda S. Expressed emotion and short-term treatment outcome of outpatients with major depression. Compr Psychiatry 1996; 37: 299-304.
- Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967; 6: 278-96.
- Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-71.
- Leff J, Vearnals S, Wolff G, Alexander B, Chisholm D, Everitt B, et al. The London Depression Intervention Trial. Randomised controlled trial of antidepressants v. couple therapy in the treatment and maintenance of people with depression living with a partner: clinical outcome and costs. Br J Psychiatry 2000; 177: 95-100.
- Sackeim HA. Continuation therapy following ECT: directions for future research. Psychopharmacol Bull 1994; 30: 501-21.
Cited by
Sorted by citations
Yesufu-Udechuku, A., Harrison, B., Mayo-Wilson, E., Young, N., Woodhams, P., Shiers, D., Kuipers, E., & Kendall, T. (2015) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.147561 · Cited by 294 · see citing works
Sim, K., Lau, W. K., Sim, J., Sum, M. Y., & Baldessarini, R. J. (2016) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyv076 · Cited by 218 · see citing works
“Among these, notably, family psychoeducation continued for up to 10 months was examined in two Japanese studies and found to be clinically effective and cost-effective in reducing recurrence risks in major depressive disorder patients (Shimazu et al., 2011; Shimodera et al., 2012).”
BackgroundInfluentialBauer, M., Severus, E., Köhler, S., Whybrow, P. C., Angst, J., Möller, H.-J., & on behalf of the Wfsbp Task Force on Treatment Guidelines for Unipolar Depressive Disorders (2015) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2014.1001786 · Cited by 199 · see citing works
“Furthermore initial data hint at the effectiveness of family psychoeducation (Shimazu et al. 2011).”
BackgroundEffectiveness of psychoeducation for depression: A systematic review
Tursi, M. F. D. S., Baes, C. V. W., Camacho, F. R. D. B., Tofoli, S. M. D. C., & Juruena, M. F. (2013) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867413491154 · Cited by 173 · see citing works
“A brief family PE is effective in the prevention of relapse (Shimazu et al., 2011) and a reduction of the psychosocial burden of relatives of patients with MDD (Katsuki et al., 2011).”
BackgroundMethodResultInfluentialS3-Leitlinie Psychosoziale Therapien bei schweren psychischen Erkrankungen
Erkrankungen, P., Hrsg, D., & Riedel-Heller, S. (2019) · Springer eBooks · doi:10.1007/978-3-662-58284-8 · Cited by 167 · see citing works
“11 die Reduktion des Rückfallrisikos [688].”
BackgroundInfluentialBaumel, A., Tinkelman, A., Mathur, N., & Kane, J. M. (2018) · JMIR mHealth and uHealth · doi:10.2196/mhealth.9482 · Cited by 101 · see citing works
“While previous studies demonstrated positive outcomes for the use of peer-assisted interventions [41,42] and family involvement [43], their impacts were limited by the need to develop and implement practical methods to engage, screen, and train lay people from the community to support others.”
Keeping therapies simple: psychoeducation in the prevention of relapse in affective disorders
Colom, F. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.090209 · Cited by 99 · see citing works
“The current issue of British Journal of Psychiatry contains a good example of psychoeducation for unipolar disorder; 10 an extremely simple psychoeducational intervention improving clinical outcomes in a group of patients with different severity of illness, which proves both the efficacy and…”
Lambert, S. D., Duncan, L. R., Kapellas, S., Bruson, A.-M., Myrand, M., Santa Mina, D., Culos-Reed, N., & Lambrou, A. (2016) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9819-3 · Cited by 98 · see citing works
Family engagement as part of managing patients with mental illness in primary care.
Ong, H. S., Fernandez, P., & Lim, H. K. (2021) · Singapore medical journal · doi:10.11622/smedj.2021057 · Cited by 96 · see citing works
“Studies have shown that family engagement helps to ease family burden and carer stress,(31,48-50) as well as reducing expressed emotions in family members and carers.”
BackgroundVan Leeuwen, E., van Driel, M. L., Horowitz, M. A., Kendrick, T., Donald, M., De Sutter, A. I., Robertson, L., & Christiaens, T. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013495.pub2 · Cited by 90 · see citing works
Consumer and family psychoeducation: assessing the evidence.
Lyman, D. R., Braude, L., George, P. E., Dougherty, R., Daniels, A. S., Ghose, S., & Delphin-Rittmon, M. E. (2014) · Psychiatric Services · doi:10.1176/appi.ps.201300266 · Cited by 59 · see citing works
Brady, P., Kangas, M., & McGill, K. M. (2017) · Journal of Marital & Family Therapy · doi:10.1111/jmft.12204 · Cited by 46 · see citing works
Report of the APSAC Task Force on Evidence-Based Service Planning Guidelines for Child Welfare
Berliner, L., Fitzgerald, M., Dorsey, S., Chaffin, M., Ondersma, S. J., & Wilson, C. (2015) · Child Maltreatment · doi:10.1177/1077559514562066 · Cited by 46 · see citing works
Relatives of patients with depression: experiences of everyday life.
Skundberg-Kletthagen, H., Wangensteen, S., Hall-Lord, M.-L., & Hedelin, B. (2014) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12082 · Cited by 46 · see citing works
Baumel, A. (2015) · Journal of Mental Health · doi:10.3109/09638237.2015.1079308 · Cited by 44 · see citing works
“Carter, 2011), family involvement in therapy (Shimazu et al., 2011), and task shifting of coaches (Bosmans et al.”
BackgroundShimodera, S., Furukawa, T. A., Mino, Y., Shimazu, K., Nishida, A., & Inoue, S. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-40 · Cited by 43 · see citing works
“We have recently demonstrated the efficacy of a new approach to recurrent depression, namely family psychoeducation [7], which has been proven to be effective and cost-effective for the treatment of schizophrenia [8,9].”
BackgroundSelf-citationSystematic review of dyadic and family‐oriented interventions for late‐life depression
Stahl, S. T., Rodakowski, J., Saghafi, E. M., Park, M., Reynolds, C. F., & Dew, M. A. (2016) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4434 · Cited by 40 · see citing works
“Two studies focused on treating MDD only (Shimazu et al., 2011 & Shimodera et al., 2012; Teri et al. 1997); six studies focused on alleviating symptoms of depression only (Mittelman et al., 2000; 2004 & 2008; Eisdorfer et al., 2003; Wilz and Barskova, 2007; Gaugler et al., 2008), and two studies…”
BackgroundMethodInfluentialKatsuki, F., Watanabe, N., Yamada, A., & Hasegawa, T. (2022) · BJPsych Open · doi:10.1192/bjo.2022.543 · Cited by 45 · see citing works
Psychoeducation for major depressive disorders: A randomised controlled trial
Morokuma, I., Shimodera, S., Fujita, H., Hashizume, H., Kamimura, N., Kawamura, A., Nishida, A., Furukawa, T. A., & Inoue, S. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.05.018 · Cited by 31 · see citing works
“In fact, we conducted family psychoeducation which sets a goal of reducing the family's EE for members with major depression and found that the time to relapse was much longer in the intervention group than in the control group (Shimazu et al., 2011).”
Self-citationRummel-Kluge, C., Kluge, M., & Kissling, W. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-170 · Cited by 33 · see citing works
“This is surprising, as there is empirical evidence that psychoeducational programs for family members for several psychiatric conditions are in fact effective [2,13-17].”
Backgroundda Silva, G. D. G., Jansen, K., Barbosa, L., Branco, J. D. C., Pinheiro, R., Magalhães, P. V. D. S., Kapczinski, F., & da Silva, R. A. (2014) · International Journal of Social Psychiatry · doi:10.1177/0020764013491740 · Cited by 29 · see citing works
“However, these informal caregivers do not usually have the required information and resourcefulness to deal with the burden caused by the disorder, often making them markedly distressed themselves and likely to be socially isolated (Shimazu et al., 2011).”
BackgroundKatsuki, F., Takeuchi, H., Inagaki, T., Maeda, T., Kubota, Y., Shiraishi, N., Tabuse, H., Kato, T., Yamada, A., Watanabe, N., et al. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1788-6 · Cited by 21 · see citing works
“[14] to reduce families’ burden, with each session consisting of the families of approximately four patients.”
BackgroundMethodResultInfluentialSelf-citationStigma and discrimination: A socio-cultural etiology of mental illness.
Levy, B., Celen‐Demirtas, S., Surguladze, T., & Sweeney, K. K. (2014) · The Humanistic Psychologist · doi:10.1080/08873267.2014.893513 · Cited by 20 · see citing works
Frank, F., Rummel‐Kluge, C., Berger, T., Bitzer, E. M., & Hölzel, L. P. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-143 · Cited by 16 · see citing works
“As PGIR are judged as helpful by relatives with respect to information regarding the illness and strategies for dealing with the patient [43], as they could reduce the burden of relatives [28] and contribute to a better course of illness in patients [27], are recommended by the current German treatment guidelines [17]…”
BackgroundResultSteardo, L., Caivano, V., Sampogna, G., di Cerbo, A., Fico, G., Zinno, F., Vecchio, V. D., Giallonardo, V., Torella, M., Luciano, M., et al. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00055 · Cited by 17 · see citing works
Tham, S. S., & Solomon, P. (2024) · Psychiatric Services · doi:10.1176/appi.ps.20230452 · Cited by 21 · see citing works
[The affective disorder-related burden imposed on the family environment--an overview].
Borowiecka-Kluza, J., Miernik-Jaeschke, M., Jaeschke, R., Siwek, M., & Dudek, D. (2013) · Psychiatria Polska · doi:10.12740/pp/17859 · Cited by 14 · see citing works
“[56] indicate that providing psychoeducation to relatives of patients with MDD (in the absence of patients themselves) over the period of nine weeks did reduce FB severity, a review by Luciano et al.”
BackgroundLatifian, M., Raheb, G., Abdi, K., Alikhani, R., & Islam, S. M. S. (2022) · PsyCh Journal · doi:10.1002/pchj.621 · Cited by 13 · see citing works
The efficacy of psychoeducation on recurrent depression: a randomized trial with a 2-year follow-up
Aagaard, J., Foldager, L., Makki, A., Hansen, V., & Müller-Nielsen, K. (2016) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2016.1266385 · Cited by 11 · see citing works
“Thus, only few controlled studies focusing on the efficacy of psychoeducation and medical treatment in recurrent depression have been conducted (5,18,22).”
BackgroundAbortion and mental health: guidelines for proper scientific conduct ignored
Goldacre, B., & Lee, W. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.200.1.77 · Cited by 13
Family psychoeducation for major depression: randomised controlled trial
Patra, B., & Subodh, B. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.200.1.82a · Cited by 12
Development of a 3‐Day Intervention Program for Family Members of Hikikomori Sufferers
Kubo, H., Urata, H., Sakai, M., Nonaka, S., Kishimoto, J., Saito, K., Tateno, M., Kobara, K., Fujisawa, D., Hashimoto, N., et al. (2021) · Japanese psychological research (Print) · doi:10.1111/jpr.12368 · Cited by 11 · see citing works
“A previous study reported that such familial factors are essential variables underpinning improved outcomes among individuals with depression (Shimazu et al., 2011).”
BackgroundBijker, L., Kleiboer, A., Riper, H., Cuijpers, P., & Donker, T. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.06.003 · Cited by 10 · see citing works
Timmerby, N., Austin, S., Ussing, K., Bech, P., & Csillag, C. (2016) · Trials · doi:10.1186/s13063-016-1549-0 · Cited by 10 · see citing works
“[19] here found a relapse rate in the 9-month follow-up period of 8 % in the intervention group and 50 % in the control group.”
BackgroundMethodResultInfluentialSvenning, A., Panzarino, R. W., Vanryckeghem, M., & Vestner, T. (2020) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2020.105821 · Cited by 9 · see citing works
Kudo, S., Tomita, T., Sugawara, N., Sato, Y., Ishioka, M., Tsuruga, K., Nakagami, T., Nakamura, K., & Yasui-Furukori, N. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s93657 · Cited by 9 · see citing works
“For example, some studies have reported that psychoeducation improved antidepressant adherence(11,12) and that psychoeducation decreased the symptoms of patients with depression(13) and effectively prevented relapse.(14,15) In a meta-analysis, Donker et al concluded that brief passive psychoeducation interventions cou…”
ResultKatsuki, F., Takeuchi, H., Watanabe, N., Shiraishi, N., Maeda, T., Kubota, Y., Suzuki, M., Yamada, A., & Akechi, T. (2014) · Trials · doi:10.1186/1745-6215-15-320 · Cited by 9 · see citing works
“One randomized controlled trial found that family psychoeducation is effective in enhancing the course of MDD [29].”
BackgroundShiraishi, N., Watanabe, N., Kinoshita, Y., Kaneko, A., Yoshida, S., Furukawa, T., & Akechi, T. (2014) · Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000064 · Cited by 9 · see citing works
“Knowledge conveyed with consideration for their psychological states enables them to cope with problems and troubles caused by mental disorders (Katsuki et al., 2011; Pitschel-Walz et al., 2001; Shimazu et al., 2011).”
BackgroundSelf-citationWalther, A., Schneeberger, M., & Eggenberger, L. (2024) · Psychotherapy Research · doi:10.1080/10503307.2024.2398085 · Cited by 8 · see citing works
“Furthermore, theoretically specified factors within psychoeducation for MDD (e.g., increased knowledge about MDD symptoms and potential disease course) have been shown to have positive effects on MDD outcomes (Morokuma et al., 2013; Shimazu et al., 2011; Tursi et al., 2013).”
Saito, T., Takahashi, H., Tsujii, N., Sasaki, T., Yamaguchi, Y., Takatsu, M., & Sato, M. (2023) · Journal of child and adolescent psychopharmacology · doi:10.1089/cap.2023.0048 · Cited by 8 · see citing works
Frank, F., Wilk, J., Kriston, L., Meister, R., Shimodera, S., Hesse, K., Bitzer, E., Berger, T., & Hölzel, L. P. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0633-4 · Cited by 10 · see citing works
“[17] are encouraging, and are in line with results for psychoeducation for relatives in other mental disorders [7–10].”
BackgroundMethodResultInfluentialSelf-citationRexhaj, S., Monteiro, S., Golay, P., Coloni-Terrapon, C., Wenger, D., & Favrod, J. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-038781 · Cited by 7 · see citing works
Ducasse, D., Courtet, P., Sénèque, M., Genty, C., Picot, M., Schwan, R., & Olié, É. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0667-7 · Cited by 6 · see citing works
“Psychoeducation in MDD was shown to: 1) reduce depressive symptoms [5, 14 – 29], 2) reduce the risk of relapse or recurrence [26, 30 – 33], 3) improve treat-ment adherence [17, 18, 34], 4) increase quality of life [29] and global functionning [25, 35].”
BackgroundBipolar I disorder and expressed emotion of families: A cohort study in Japan
Shimodera, S., Yonekura, Y., Yamaguchi, S., Kawamura, A., Mizuno, M., Inoue, S., Furukawa, T., & Mino, Y. (2012) · Open Journal of Psychiatry · doi:10.4236/ojpsych.2012.24035 · Cited by 6 · see citing works
Self-citationTomita, T., Kudo, S., Sugawara, N., Fujii, A., Tsuruga, K., Sato, Y., Ishioka, M., Nakamura, K., & Yasui-Furukori, N. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s156797 · Cited by 5 · see citing works
Frank, F., Hasenmüller, M., Kaiser, M., Ries, Z., Bitzer, E., & Hölzel, L. (2015) · Psychotherapie - Psychosomatik - Medizinische Psychologie · doi:10.1055/s-0035-1555787 · Cited by 5
Hirota, M., Chiba, R., Aoyama, S., Hirano, Y., Ichikawa, K., Greiner, C., Fujimoto, H., Yotsumoto, K., & Hashimoto, T. (2023) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20230524-01 · Cited by 4 · see citing works
Aitken, M., Sagar, A., Courtney, D., & Szatmári, P. (2023) · JCPP Advances · doi:10.1002/jcv2.12168 · Cited by 4 · see citing works
“� Further research is needed to test effects on caregiver ‐ adolescent relationship problems in a randomised controlled trial. family therapy (Friedman, 1989; Graybill, 1986; Katsuki et al., 2011; Leff et al., 1990; Shimazu et al., 2011).”
BackgroundSchramm, E., Breuninger, C., Zehender, N., Hegerl, U., Elsner, A., Maun, A., Schmölz, M., Roick, C., Grodd, M., & Graf, E. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04035-6 · Cited by 4 · see citing works
Kamalah, A., Ahsan, A., & Kristianto, H. (2016) · doi:10.21776/ub.jik.2016.004.02.1 · Cited by 4
Trajectories of parent criticism across treatment for youth self‐harm
Aitken, M., Perquier, F., Park, B., Carvalho, D., Wright-Hughes, A. M., Cottrell, D. J., & Szatmári, P. (2025) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14144 · Cited by 7 · see citing works
“…studies have generally examined group-level changes across treatment (Eisler et al., 2000; Katsuki et al., 2011; O’Brien, Miklowitz, & Cannon, 2015; Shimazu et al., 2011), which assumes that change is homogeneous; however, at least one study in youth with anorexia suggests that parents show…”
Biegańska, J. (2016) · Archives of Psychiatry and Psychotherapy · doi:10.12740/app/62182 · Cited by 3 · see citing works
Sano, T., Yonemoto, N., Narita, K., Nemoto, K., Ishibashi, R., Hirayasu, Y., & Kawanishi, C. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116865 · Cited by 2 · see citing works
Obieche, O., Tan, J., Sharma, S., Bressington, D., & Wang, T. (2025) · Nursing Reports · doi:10.3390/nursrep15100364 · Cited by 2 · see citing works
“Some existing studies involved only patients [14,15] or patients’ family members or caregivers [12,16].”
Sağbaş, S., Korkmaz, Ş., & Öyekçin, D. (2025) · Clinical Psychology and Psychotherapy · doi:10.1002/cpp.70165 · Cited by 2 · see citing works
Toni, C., Luciano, M., Arsenio, E., Boiano, A., Corvino, E., Rocca, B. D., Lapadula, M. V., Tretola, L., Sampogna, G., & Fiorillo, A. (2023) · Brain Science · doi:10.3390/brainsci13081199 · Cited by 2 · see citing works
Freher, N. K., Bexkens, A., van Bennekom, M. J., Veling, W., & Bockting, C. (2022) · Psychiatry Research Communications · doi:10.1016/j.psycom.2022.100086 · Cited by 3 · see citing works
Mother-Daughter Relationships in the Recovery and Rehabilitation of Women with Major Depression
Mesidor, M. M., & Maru, M. (2015) · Women & Therapy · doi:10.1080/02703149.2014.978222 · Cited by 2 · see citing works
“…can benefit from becoming knowledgeable about different approaches to providing family psychoeducation, as they have been identified as effective interventions that can help family members coping with challenges related to serious mental illness (e.g., Shimazu et al., 2011; Stam & Cuijpers, 2001).”
BackgroundPfeiffer, S., & In-Albon, T. (2021) · Reference Module in Neuroscience and Biobehavioral Psychology · doi:10.1016/b978-0-12-818697-8.00080-7 · Cited by 2 · see citing works
Schramm, E., Zehender, N., Breuninger, C., Hegerl, U., Elsner, A., Maun, A., Schmölz, M., Roick, C., Sahlmann, J., Grodd, M., et al. (2025) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2025.101560 · Cited by 1 · see citing works
“16 However, there is an under-supply of psychoeducational offers for families of patients with depression.”
Tomita, T., Kudo, S., Sugawara, N., Fujii, A., Tsuruga, K., Sato, Y., Ishioka, M., Nakamura, K., & Yasui-Furukori, N. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s207544 · Cited by 1 · see citing works
“For example, some studies have shown that the psychoeducational approach improves adherence to pharmacological treatment,(6,7) decreases the depressive symptoms of patients,(8) and prevents relapse.(9,10) In a meta-analysis, Donker et al concluded that brief, passive psychoeducational interventions may improve depress…”
ResultFamily Inclusive Therapeutic Interventions
Wilson, A., Ibrahim, S., Clerici, M., di Giacomo, E., & Keitner, G. (2018) · Advances in Psychiatry · doi:10.1007/978-3-319-70554-5_11 · Cited by 1 · see citing works
Juretić, T. G., Letica-Crepulja, M., Stevanović, A., Ružić, K., Rončević-Gržeta, I., & Došen, A. (2020) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2019.11.001 · Cited by 1 · see citing works
Gesundheitskommunikation als transdisziplinäres Forschungsfeld
Grimm, M., & Lampert, C. (2017) · doi:10.5771/9783845285290 · Cited by 1
“Des Weiteren sind Angehörige zum Teil sozial isoliert (Shimazu et al., 2011) und fühlen sich stigmatisiert (Huber et al.”
BackgroundNakamura, H., Okawa, S., Tanoue, H., Goto, Y., Matsuzawa, A., & Ito, K. (2026) · JMIR Research Protocols · doi:10.2196/105182
“However, existing research has primarily focused on middle-aged and older spouses or parents, and intervention studies specifically targeting young adult caregivers remain limited [11,12].”
Obieche, O., Tan, J., Sharma, S., Bressington, D., & Wang, T. (2026) · Issues in Mental Health Nursing · doi:10.1080/01612840.2026.2704658
Die Rolle der Angehörigen in der Depressionsbehandlung
Zehender, N., & Schramm, E. (2026) · PSYCH up2date · doi:10.1055/a-2602-2620
“…höheren Behandlungszufrieden-heit seitens des Patienten einhergingen. reiner Wissensvermittlung auch Problemlöse-und Coping-Strategien beinhalten, können die objektive zeigten sich reduzierte Rückfallraten der Erkrankten, wenn die Angehörigen an den Psychoedukationskursen teilgenommen haben [18].”
Unterstützungsangebote für Angehörige von depressiv Erkrankten
Schmölz, M., Maun, A., Elsner, A., Zehender, N., Breuninger, C., & Schramm, E. (2022) · Zeitschrift fur Allgemeinmedizin · doi:10.53180/zfa.2022.0294-0297
“Psychoedukative Inter-ventionen für Angehörige führen, neben der Verbesserung des eigenen Be-findens, nachweislich zu einer Reduktion von depressiven Symptomen der Betroffenen oder reduzieren sogar ein Wiederauftreten von Depressionen [18, 19].”
BackgroundInfluentialA case study of person with depression: a cognitive behavioural case work approach
Saikia, P., Gujar, N., & Ali, A. (2020) · doi:10.25215/0803.072
Tomita, T., Kudo, S., Sugawara, N., Fujii, A., Tsuruga, K., Sato, Y., Ishioka, M., Nakamura, K., & Yasui-Furukori, N. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s158254
“and that the symptoms of patients with depression were decreased by psychoeducation(17) and relapse was effectively prevented.(18,19) In a metaanalysis, Donker et al concluded that”
BackgroundAssessment and Support Consultation: Enhancing Social Support for Sexual Offenders
Hawkins, K., & Eddie, D. (2013) · International Journal of Forensic Mental Health · doi:10.1080/14999013.2013.819397
“Across clinical presentations, there is strong evidence for the benefits of including social supports in the treatment (e.g., Copello et al., 2005; McCrady et al., 2009; McGorry, 2009; Rea et al., 2003; Shimazu et al., 2011).”
BackgroundShimodera, S. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.200.1.82b
Self-citationZigmond, T. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.200.1.82
Mela, M. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.200.1.81a
Cost of commercial protectionism in child health research
Houghton, F. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.199.2.164
Clinical trials of drug and behaviour therapies: methodological issues
Biswas, P., Sen, D., & Sinha, V. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.199.2.165
Woznac, R. W. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.199.2.164a
Family Psychoeducation Reduces Relapse in Major Depression
Roy-Byrne, P. (2011) · Journal watch · doi:10.1056/jp201107180000001
- Authors
- Shimazu, K., Shimodera, S., Mino, Y., Nishida, A., Kamimura, N., Sawada, K., Fujita, H., Furukawa, T. A., & Inoue, S.
- Affiliations
- Kochi Medical School Hospital (JP)
- Mie University (JP)
- Kōchi University (JP)
- Kyoto University (JP)
- Corresponding author
- Shimodera, Shinji
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2011-05
- Volume
- 198
- Issue
- 5
- Pages
- 385-390
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2163557283
- Cited by
- 95
- References
- 35
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 8 · 2017: 3 · 2016: 7 · 2015: 16 · 2014: 6 · 2013: 9 · 2012: 7
- FWCI
- 9.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health, Labour and Welfare
- Japan Society for the Promotion of Science (23118002)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- family psychoeducation, major depressive disorder, relapse prevention, maintenance therapy, expressed emotion, family involvement in treatment, group problem solving, Five Minute Speech Sample
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Depressive Disorder, Major, Major Depressive Disorder, Family Health, Family Relations, Female, Health Education, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Psychiatric Status Rating Scales, Verbal Behavior, Survival Analysis, Treatment Outcome, Expressed Emotion, Secondary Prevention, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
