Integration of family and drug treatment strategies in the treatment of schizophrenia: a selective review.

It is often asserted that maintenance treatment in schizophrenia requires the integration of both medication and psychosocial treatment for maximum benefit. A review of research on one psychosocial treatment, psychoeducational family treatment, suggests that it provides benefits beyond other psychosocial treatments or usual care, but there is no evidence of differences among family treatments. Research designs that include comparisons of both medication and psychosocial treatment provide the strongest evidence regarding the contribution of each to outcome. Two studies have incorporated comparisons of both medication and family treatment. In a short-term study that compared family treatment to routine care, family treatment had an additive effect to that of medication. Goldstein and his colleagues found that subjects who received both a higher dose of medication and family treatment had the best outcome. In a longer term study that compared two forms of family treatment and three doses of antipsychotic medication, Schooler and her colleagues found significant effects of the medication condition but no differential effects between the two family treatments. Taken together, these studies support a clinical recommendation that when family members are available, a psychoeducational family treatment should be part of an overall treatment program for schizophrenia.