The Effects of an Online Family Psychoeducation Program on Expressed Emotion of Family Members and Medication Adherence of Patients With First-Episode Schizophrenia

The investigators examined if LINE family Psychoeducation Program plus routine treatment is effective for reducing Expressed Emotion and improving Medication Adherence in real practice. Family members and patients with first-episode schizophrenia received a 7-week online family psychoeducation program via the LINE application, while the control group received routine care. Family caregivers completed the Thai Expressed Emotion Scale (TEES) and the Medication Adherence Report Scale (MARS). Baseline assessments were conducted prior to group allocation. Post-intervention assessments were conducted at week 8. Intervention fidelity was monitored through weekly quizzes and researcher oversight.

Inclusion criteria

for patients were:

• a diagnosis of schizophrenia according to the International Classification of Diseases, 10th Revision ICD-10 (F20.00 to F20.09), with a duration of illness not exceeding five years from the date of initial diagnosis
• received oral antipsychotic treatment for at least 6 months but no longer than five years
• aged between 18 to 35 years.
• mild psychotic symptoms severity, defined as a total score of 18 to 36 on the Brief Psychiatric Rating Scale (BPRS)
• documented history of medication non-adherence, as recorded in medical records
• availability of a primary caregiver and
• ability to communicate in Thai and via telephone using the LINE application

Inclusion criteria

for family members were:

• being a family member living in the same household as the patients and serving as the primary caregiver for at least six months without financial compensation
• Aged 20 to 60 years
• ownership of a mobile phone capable of using the LINE application
• no prior participation in family psychoeducation programs
• ability to speak, read, and write Thai
• no history of psychiatric disorders, including schizophrenia, bipolar disorder, or major depressive disorder.

Exclusion criteria

for both patients and caregivers were:

• acute exacerbation of psychotic symptoms requiring hospitalization during the study period
• missing one or more scheduled intervention sessions
• inability of the researcher to contact the family caregiver within one week despite repeated attempts.