group. This improvement was not sustained in the medium term.
Without more data, it is difficult to conclude if psychoeducation
is indeed better than standard care on reducing expressed emotion
in relatives, but these and other findings are consistent with the
picture of psychoeducation helping the person as well as the family
dealing with the illness.
1.11 Quality of life
Again the various measures serve to confuse rather than clarify.
Data tended to be equivocal or favour the psychoeducation group.
Consistency ofmeasure as well asmore data are needed before anyone
can be confident of the effects of psychoeducation on quality
of life.
1.12 Satisfaction
Only Brief - Group 1999 reported on patients and relatives’ satisfaction
using the VSS scale. Most data indicated an equivocal
effect between groups. This is an important outcome. It is to the
credit of those designing Brief - Group 1999 that they have considered
the satisfaction of patients and relatives - but much more
data are needed to understand how psychoeducation really effects
this outcome.
1.13 Adverse event: Death
Across the time periods of the few studies that reported on this
outcome (about two years) about 1%of people died. There was no
suggestion that psychoeducation had any effect on this outcome.
1.14 Economic outcome
As is frequent, economic data were few and skewed. It would seem
likely that, if psychoeducation does really have an effect on relapse
and service use that, if recorded properly and reported clearly, there
should be an economic effect to find.
2. Subgroup analyses 1. Brief psychoeducation/standard
psychoeducation versus standard care
For subgroup analyses we found no direct comparisons.We therefore
compared each approach (brief/standard and group/individual)
with the standard (non-psychoeducational) care.We are aware
that techniques are available to undertake indirect comparisons
of interventions (section 16.6.2 of Cochrane Handbook, Higgins
2008) but have not employed these at this juncture on such weak
data.