Family‐based interventions versus standard care for people with schizophrenia

Background People with schizophrenia often experience long‐term psychosocial disabilities and frequent relapse. Family plays a key role in caring for ill relatives, which in turn probably contributes to high levels of distress and burdens for the family. Family‐based interventions have been developed and applied to family members and their relatives with schizophrenia to improve their outcomes. This is an update of a Cochrane review that was last updated in 2011, which has been split into this review, one on group‐ versus individual‐based family interventions and one on family‐based cognitive versus behavioural management interventions. Objectives To assess the effects of family‐based interventions for people with schizophrenia or schizophrenia‐like disorders and their families compared with standard care. Search methods We searched the following electronic databases from inception until April 2023: CENTRAL, Medline, Embase, PsycInfo, CINAHL, WHO International Clinical Trials Registry Platform (ICTRP), Clinicaltrials.gov, SinoMed, China Network Knowledge Infrastructure (CNKI), Wanfang, and Chinese Scientific Journals Database (VIP). We also searched the reference lists of included studies and accessible reviews for additional references. Selection criteria We included randomised controlled trials (RCTs) that compared the effects of family‐based interventions for people with schizophrenia or schizophrenia‐like disorders and their families and reported at least one patient’s and one family member’s outcomes. In this update, we only investigated standard care as the comparator. Data collection and analysis We used standard Cochrane methods. The review authors independently screened studies, extracted data, and assessed risk of bias for each study using the Cochrane risk of bias tool for RCTs. We pooled data and estimated effects with the mean difference (MD), standardised mean difference (SMD), or risk ratio (RR) with 95% confidence interval (CI). We judged the certainty of evidence using GRADEpro GDT. We divided the outcomes into short‐term (≤ 1 month postintervention), medium‐term (> 1 to 6 months postintervention), and long‐term follow‐up (> 6 months postintervention), if available. Main results We identified 26 RCTs in this review, with 1985 people with schizophrenia or schizophrenia‐like disorders, and 2056 family members. Most family‐based interventions were conducted on a weekly or biweekly basis, with duration ranging from five weeks to two years. We