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Effects on family functioning and the home environment of a family-based preventive intervention for children of parents with severe mental illness: A randomized controlled trial.
Journal of Consulting and Clinical Psychology ( IF 4.5 ) Pub Date : 2024-12-12 , DOI: 10.1037/ccp0000924
Ida Christine Tholstrup Gjøde,Anne Dorothee Müller,Carsten Hjorthøj,Nicoline Hemager,Sidsel Ingversen,Mala Moszkowicz,Sofie Heidenheim Christensen,Lisbeth Juhl Mikkelsen,Signe Sofie Nielsen,Marianne Melau,Julie Forman,Merete Nordentoft,Anne Amalie Elgaard Thorup

OBJECTIVE Children of parents with severe mental illness are at increased risk of mental illness throughout their lifespan due to complex gene-environment interactions. Preventive interventions supporting parents and children are warranted. Compared with usual treatment, we tested the effectiveness of a multidisciplinary family-based preventive intervention, VIA Family. METHOD We did a parallel randomized controlled superiority trial in Copenhagen, Denmark. A total of 95 families, of 95 parents with either schizophrenia spectrum disorder (n = 12 [12.6%]), bipolar disorder (n = 25 [26.3%]), or recurrent major depressive disorder (n = 58 [61.1%]), participated. A total of 179 coparents and 113 children (6-12 years) participated. Assessments took place at baseline and after 18 months of intervention. We estimated the effects on family functioning with the McMaster Family Assessment Device and on levels of stimulation and support in the home environment with the Home Observation Measurement of the Environment. RESULTS Effects on family functioning did not differ between the two groups: parents with severe mental illness (0.11; 95% CI [-0.10, 0.31]), p = .296, and coparents (-0.07; 95% CI [-0.27, 0.13]), p = .482. Assessor-rated levels of stimulation and support in the home environment improved in VIA Family, but not significantly compared with usual treatment (Mdiff: 1.79; 95% CI [-0.37, 3.95], p = .104). Sensitivity analyses confirmed our main findings. CONCLUSIONS Effects on family functioning and the home environment did not differ between VIA Family and usual treatment. We cannot rule out a clinically relevant effect of VIA Family on levels of stimulation and support in the home environment. Long-term follow-up will investigate potential preventive effects. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译:


对患有严重精神疾病的父母的孩子进行基于家庭的预防性干预对家庭功能和家庭环境的影响:一项随机对照试验。



目的 由于复杂的基因-环境相互作用,父母患有严重精神疾病的孩子在其一生中患精神疾病的风险增加。有必要为父母和儿童提供支持的预防性干预。与常规治疗相比,我们测试了基于家庭的多学科预防干预 VIA Family 的有效性。方法 我们在丹麦哥本哈根进行了一项平行随机对照优效性试验。共有 95 个家庭参与,其中 95 名父母患有精神分裂症谱系障碍 (n = 12 [12.6%])、双相情感障碍 (n = 25 [26.3%]) 或复发性重度抑郁症 (n = 58 [61.1%])。共有 179 名共同父母和 113 名儿童(6-12 岁)参与。评估在基线和干预 18 个月后进行。我们估计了使用 McMaster 家庭评估设备对家庭功能的影响,以及使用家庭观察环境测量对家庭环境中刺激和支持水平的影响。结果 两组对家庭功能的影响没有差异:患有严重精神疾病的父母(0.11;95% CI [-0.10,0.31]),p = .296,以及共同父母(-0.07;95% CI [-0.27,0.13]),p = .482。VIA Family 中评估者评定的家庭环境中的刺激和支持水平有所改善,但与常规治疗相比没有显着改善(Mdiff: 1.79;95% CI [-0.37, 3.95],p = .104)。敏感性分析证实了我们的主要发现。结论 VIA Family 和常规治疗对家庭功能和家庭环境的影响没有差异。我们不能排除 VIA Family 对家庭环境中刺激和支持水平的临床相关影响。长期随访将调查潜在的预防效果。 (PsycInfo 数据库记录 (c) 2024 APA,保留所有权利)。
更新日期:2024-12-12
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