Meta-review of systematic and meta-analytic reviews on family psychoeducation for schizophrenia

The purpose of family psychoeducation is to increase patients’ and their families’ knowledge and understanding of their illness and treatment. Improved knowledge of schizophrenia is expected to enable people to cope better with their illness. The aim of this review is to summarize and appraise evidence from published systematic and meta-analytic reviews on family psychoeducation in schizophrenia. Thorough search and analysis of reviews on efficacy of family psychoeducation in schizophrenia were carried out in PubMed/Medline (19872015), Ovid/Psych Info (1987-2015), and the Cochrane Database of Systematic Reviews. We included only reviews reporting quantitative summary statistics on studies carried out in patients with schizophrenia and written in English. Review methodology was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist. Double check by two independent assessors was applied. Nine reviews meeting inclusion/exclusion criteria were included in the meta-review. Risk of relapse was reduced in protocols that included family members, whether conducted in single family or in multifamily group sessions. However, effectiveness seems not to be maintained at follow-up. Hospital admission/re-hospitalization was less influenced by family psychoeducation, and no reproducible effect on compliance/medication adherence was found. Overall, quality of evidence on the effectiveness of family psychoeducation in schizophrenia is poor