Amina Yesufu-Udechuku1, Bronwyn Harrison1, Evan Mayo-Wilson1, Norman Young1, Peter Woodhams1, David Shiers1, Elizabeth Kuipers1, Tim Kendall1. 1. Amina Yesufu-Udechuku, PhD, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London; Bronwyn Harrison, BSc, National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK; Evan Mayo-Wilson, DPhil, Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Norman Young, MSc, Cardiff and Vale UHB and Cardiff University, Whitchurch Hospital, Cardiff; Peter Woodhams, MCIPD, Carer, Alveston, Stratford upon Avon; David Shiers, MBChB, retired GP, National Audit of Schizophrenia, Royal College of Psychiatrists, London; Elizabeth Kuipers, PhD, Department of Clinical Psychology, King's College London, Institute of Psychiatry, and National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit, London; Tim Kendall, FRCPsych, National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK.
Abstract
BACKGROUND: Informal caregiving is an integral part of the care of people with severe mental illness, but the support needs of those providing such care are not often met. AIMS: To determine whether interventions provided to people caring for those with severe mental illness improve the experience of caring and reduce caregiver burden. METHOD: We conducted a systematic review and meta-analyses of randomised controlled trials (RCTs) of interventions delivered by health and social care services to informal carers (i.e. family or friends who provide support to someone with severe mental illness). RESULTS: Twenty-one RCTs with 1589 carers were included in the review. There was evidence suggesting that the carers' experience of care was improved at the end of the intervention by psychoeducation (standardised mean difference -1.03, 95% CI -1.69 to -0.36) and support groups (SMD = -1.16, 95% CI -1.96 to -0.36). Psychoeducation had a benefit on psychological distress more than 6 months later (SMD = -1.79, 95% CI -3.01 to -0.56) but not immediately post-intervention. Support interventions had a beneficial effect on psychological distress at the end of the intervention (SMD = -0.99, 95% CI -1.48 to -0.49) as did problem-solving bibliotherapy (SMD = -1.57, 95% CI -1.79 to -1.35); these effects were maintained at follow-up. The quality of the evidence was mainly low and very low. Evidence for combining these interventions and for self-help and self-management was inconclusive. CONCLUSIONS: Carer-focused interventions appear to improve the experience of caring and quality of life and reduce psychological distress of those caring for people with severe mental illness, and these benefits may be gained in first-episode psychosis. Interventions for carers should be considered as part of integrated services for people with severe mental health problems. Royal College of Psychiatrists.
BACKGROUND: Informal caregiving is an integral part of the care of people with severe mental illness, but the support needs of those providing such care are not often met. AIMS: To determine whether interventions provided to people caring for those with severe mental illness improve the experience of caring and reduce caregiver burden. METHOD: We conducted a systematic review and meta-analyses of randomised controlled trials (RCTs) of interventions delivered by health and social care services to informal carers (i.e. family or friends who provide support to someone with severe mental illness). RESULTS: Twenty-one RCTs with 1589 carers were included in the review. There was evidence suggesting that the carers' experience of care was improved at the end of the intervention by psychoeducation (standardised mean difference -1.03, 95% CI -1.69 to -0.36) and support groups (SMD = -1.16, 95% CI -1.96 to -0.36). Psychoeducation had a benefit on psychological distress more than 6 months later (SMD = -1.79, 95% CI -3.01 to -0.56) but not immediately post-intervention. Support interventions had a beneficial effect on psychological distress at the end of the intervention (SMD = -0.99, 95% CI -1.48 to -0.49) as did problem-solving bibliotherapy (SMD = -1.57, 95% CI -1.79 to -1.35); these effects were maintained at follow-up. The quality of the evidence was mainly low and very low. Evidence for combining these interventions and for self-help and self-management was inconclusive. CONCLUSIONS: Carer-focused interventions appear to improve the experience of caring and quality of life and reduce psychological distress of those caring for people with severe mental illness, and these benefits may be gained in first-episode psychosis. Interventions for carers should be considered as part of integrated services for people with severe mental health problems. Royal College of Psychiatrists.
Authors: Luís González-de Paz; Jordi Real; Alicia Borrás-Santos; José M Martínez-Sánchez; Virginia Rodrigo-Baños; María Dolores Navarro-Rubio Journal: J Public Health Policy Date: 2016-02-11 Impact factor: 2.222
Authors: Megan E Shepherd-Banigan; Abigail Shapiro; Jennifer R McDuffie; Mira Brancu; Nina R Sperber; Courtney H Van Houtven; Andrzej S Kosinski; Neha N Mehta; Avishek Nagi; John W Williams Journal: J Gen Intern Med Date: 2018-05-07 Impact factor: 5.128
Authors: Fiona Lobban; Nadia Akers; Duncan Appelbe; Rossella Iraci Capuccinello; Lesley Chapman; Lizzi Collinge; Susanna Dodd; Sue Flowers; Bruce Hollingsworth; Mahsa Honary; Sonia Johnson; Steven H Jones; Ceu Mateus; Barbara Mezes; Elizabeth Murray; Katerina Panagaki; Naomi Rainford; Heather Robinson; Anna Rosala-Hallas; William Sellwood; Andrew Walker; Paula R Williamson Journal: Health Technol Assess Date: 2020-06 Impact factor: 4.014
Authors: Alejandra Caqueo-Urízar; Mar Rus-Calafell; Thomas K J Craig; Matias Irarrazaval; Alfonso Urzúa; Laurent Boyer; David R Williams Journal: Curr Psychiatry Rep Date: 2017-01 Impact factor: 5.285
Authors: Amy K Nuttall; Katharine N Thakkar; Xiaochen Luo; Kim T Mueser; Shirley M Glynn; Eric D Achtyes; John M Kane Journal: Psychiatry Res Date: 2019-04-16 Impact factor: 3.222
Authors: Sue Berger; Tiffany Chen; Jenna Eldridge; Cathi A Thomas; Barbara Habermann; Linda Tickle-Degnen Journal: Disabil Rehabil Date: 2017-12-12 Impact factor: 3.033