Brief multifamily Psychoeducation for family members of patients with chronic major depression: a randomized controlled trial

Fujika Katsuki, Hiroshi Takeuchi, Takahiko Inagaki, Tohru Maeda, Yosuke Kubota, Nao Shiraishi, Hideaki Tabuse, Tadashi Kato, Atsurou Yamada, Norio Watanabe, Tatsuo Akechi, Toshiaki A Furukawa, Fujika Katsuki, Hiroshi Takeuchi, Takahiko Inagaki, Tohru Maeda, Yosuke Kubota, Nao Shiraishi, Hideaki Tabuse, Tadashi Kato, Atsurou Yamada, Norio Watanabe, Tatsuo Akechi, Toshiaki A Furukawa

Abstract

Background: Major depressive disorder (MDD) is a common and often chronic problem. Patients with chronic MDD often have negative impacts on the health of their families. Family psychoeducation is recognized as part of the optimal treatment for patients with psychotic disorder, and has been shown to reduce the rate of relapse in individuals with schizophrenia and to reduce the burden on their caregivers. Thus, we predict that family psychoeducation has the potential to reduce the burden on the caregivers of patients with chronic MDD. In the present study, we aimed to investigate the effects of brief multifamily psychoeducation (BMP) on the mental health status of family members of patients with chronic MDD.

Methods: We conducted a clinical trial consisting of 49 chronic MDD patients and their families. Each family was randomly assigned to either the BMP intervention group or the control group. The intervention group received four BMP sessions, once every two weeks for eight weeks. The control group received one counseling session administered by a nurse. All patients received standard treatment administered by physicians. The primary outcome measurement was the Kessler Screening Scale for Psychological Distress (K6) score of family members at 16- weeks after the first BMP session. Secondary outcomes were depressive symptoms of both family members and patients at multiple time points, as well as family functioning as evaluated by the patients. Intention-to-treat analyses were conducted.

Results: There was no statistically significant effect of BMP on K6 scores at 16- weeks (mean difference 1.17, 95% confidence interval: - 0.63 to 2.98, P = 0.19). Exploratory analyses revealed that BMP reduced depressive symptoms in family members at 8- weeks (difference = - 3.37, 95%CI -6.32 to - 0.43, P = 0.02) and improved family functioning at multiple time points (Role; 8 W, difference = - 0.13, 95%CI -0.26 to - 0.00, P = 0.04, Affective Responsiveness; 8 W, difference = - 0.24, 95%CI -0.43 to - 0.05, P = 0.01, 32 W, difference = - 0.22, 95%CI -0.41 to - 0.03, P = 0.02, Behavior Control; 16 W, difference = - 0.17, 95%CI -0.34 to - 0.00, P = 0.04).

Conclusions: Four BMP sessions did not significantly reduce the psychological distress of family members of patients with chronic MDD.

Trial registration: Clinical Trials. gov NCT01734291 , retrospectively registered (Registration date: November 21, 2012).

Keywords: Family psychoeducation; Major depressive disorder; Randomized controlled trial.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethics Review Committee of Nagoya City University Graduate School of Medicine, Japan (Ref: No.679) and by the Ethics Committees of the participating clinics and hospitals. This study was conducted in accordance with the principles stated in the Helsinki Declaration. Written and oral informed consent were obtained from each participant prior to this study.

Consent for publication

Not applicable.

Competing interests

FK has received lecture fees from MSD. TI has received research funding from the National Mutual Insurance Federation of Agricultural Cooperatives, The Shiga Medical Science Association for International Cooperation and Shionogi. HT2 has had contracted research with Janssen, Astellas, Mitsubishi-Tanabe, Dai-Nippon-Sumitomo, and Meiji. TK has received lecture fees from Eli Lilly and Mitsubishi-Tanabe, and has contracted research with GSK, MSD, and Mitsubishi -Tanabe. AY has received lecture fees from Eli Lilly, Mochida, and Otsuka. NW has received research funds from the Japanese Ministry of Health, Labor, and Welfare, the Japanese Ministry of Education, Science, and Technology and National Center of Neurology and Psychiatry, and an Intramural Research Grant for Neurological and Psychiatric Disorders. He has received royalties from Sogensha, Paquet and Akatsuki. He is also currently acting as an Associate Editor for BMC Psychiatry. TA has received lectures fees and/or research funds from Daiichi-Sankyo, Eizai, Hisamitsu, Lilly, MSD, Meiji, Mochida, Otsuka, Pfizer, Novartis, and Terumo. He has received royalties from Igaku-Shoin, Nanzando, Kagakuhyoron-sha, and Nankodo. TAF has received lecture fees from Janssen, Meiji, MSD, Pfizer and Tanabe-Mitsubishi, and has received research support from Tanabe-Mitsubishi. He is a diplomate of the Academy of Cognitive Therapy. HT1, TM, YK and NS have nothing to declare.

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Figures

Fig. 1
Fig. 1
Participant Flow Diagram

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