Psychosocial Family Interventions for Relatives of People Living with Psychotic Disorders in the Arab World: Systematic Review

Sawafi, Aziza Saleh Al; Lovell, Karina; Renwick, Laoise; Husain, Nusrat

doi:10.21203/rs.2.24511/v2

Cited by 2 publications

(2 citation statements)

References 35 publications

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“…The associated preventive capacity is, however, limited: while a meta‐analysis found that selective psychoeducational interventions may have a small effect on reducing the severity and incidence of depression in the offspring of patients 136 , the preventive efficacy of other psychosocial interventions in young individuals with a familial vulnerability for psychotic 137 , bipolar 138 or anxiety disorders is currently unknown.…”

Section: Evidence Supporting Primary Prevention and Mental Health Promotion In Young Peoplementioning

confidence: 99%

Preventive psychiatry: a blueprint for improving the mental health of young people

et al. 2021

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Preventive approaches have latterly gained traction for improving mental health in young people. In this paper, we first appraise the conceptual foundations of preventive psychiatry, encompassing the public health, Gordon's, US Institute of Medicine, World Health Organization, and good mental health frameworks, and neurodevelopmentally‐sensitive clinical staging models. We then review the evidence supporting primary prevention of psychotic, bipolar and common mental disorders and promotion of good mental health as potential transformative strategies to reduce the incidence of these disorders in young people. Within indicated approaches, the clinical high‐risk for psychosis paradigm has received the most empirical validation, while clinical high‐risk states for bipolar and common mental disorders are increasingly becoming a focus of attention. Selective approaches have mostly targeted familial vulnerability and non‐genetic risk exposures. Selective screening and psychological/psychoeducational interventions in vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy in reducing the incidence of psychotic/bipolar/common mental disorders is unproven. Selective physical exercise may reduce the incidence of anxiety disorders. Universal psychological/psychoeducational interventions may improve anxiety symptoms but not prevent depressive/anxiety disorders, while universal physical exercise may reduce the incidence of anxiety disorders. Universal public health approaches targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) of mental disorders hold the greatest potential for reducing the risk profile of the population as a whole. The approach to promotion of good mental health is currently fragmented. We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multi‐endpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidence‐based preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the cost‐effectiveness of preventive psychiatry; and decreasing inequalities. These goals can only be achieved through an urgent individual, societal, and global level response, which promotes a vigorous collaboration across scientific, health care, societal and governmental sectors for implementing preventive psychiatry, as much is at stake for young people with or at risk for emerging mental disorders.

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Section: Evidence Supporting Primary Prevention and Mental Health Promotion In Young Peoplementioning

confidence: 99%

Preventive psychiatry: a blueprint for improving the mental health of young people

et al. 2021

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“…The Medical Research Council (MRC) framework for the development and evaluation of complex interventions was used to guide the structure of this study. (19), ( 21)…”

Section: Study Design and Purposementioning

confidence: 99%

Explore and Develop a Culturally Adopted Behavioral Psycho EducationalFamilyIntervention for Caregivers of Schizophrenic Patients inEgyptian Context

Wahid¹,

Rathinasamy²

2022

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Background: Schizophrenia is a severe enduring psychotic illness that has a profound impact on the life of the sufferer and imposes a heavy burden on their families and the community. Family interventions (FIs) are the accepted model for addressing caregivers' needs for support and information. However, there are considerable variations in their content and application. The National Institute for Clinical Excellence (NICE) has recommended that FIs should be adapted when they are delivered to non-Western populations. To date, there are few published studies, which examine FIs in the Egyptian context. Aim: To explore and develop a culturally adopted behavioral psycho educational family intervention for caregivers of schizophrenic patients in Egyptian context. Results: Four components were identified as the most frequently used out of the systematic review. Deep structure was adopted for cultural adaption. SWOT analysis identified areas of uncertainty regarding acceptability of the components. Focus group members recommended modifications to the components of the intervention to ensure its accept-ability and feasibility in the local setting. Data synthesis was conducted and the intervention was designed. Methodology: Development phase involved four stages: 1). Iden-tifying the strategies used for the cultural adaptation of FIs in non-Western cultures 2). Identifying the key components of FIs tested in the studies included in the Cochrane systematic review 3). A SWOT analysis to identify the strengths, weakness, opportunities and threats for the potential components (4).A focus group study involving caregivers and health professionals to explore the acceptability and feasibility of delivering FI in the Egyptian context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Four components were identified as the most frequently used out of the systematic review. Deep structure was adopted for cultural adaption. SWOT analysis identified areas of uncertainty regarding acceptability of the components. Focus group members recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was conducted and the intervention was designed. Conclusion :This study provides evidence of the potential efficiency and acceptability of a culturally sensitive FI for caregivers of people with schizophrenia in Egypt. However, more work needs to be done to overcome the practical challenges and test the feasibility of the intervention in more rigorous way. Also, the efficacy of the intervention needs more rigorous investigation in the context of a small scale RCT.

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Psychosocial Family Interventions for Relatives of People Living with Psychotic Disorders in the Arab World: Systematic Review

Cited by 2 publications

References 35 publications

Preventive psychiatry: a blueprint for improving the mental health of young people

Preventive psychiatry: a blueprint for improving the mental health of young people

Explore and Develop a Culturally Adopted Behavioral Psycho EducationalFamilyIntervention for Caregivers of Schizophrenic Patients inEgyptian Context

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