***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Despite the frequent use of the Positive and Negative Syndrome Scale ( PANSS ) for rating the symptoms of schizophrenia , the clinical meaning of its total score and of the cut-offs that are used to define treatment response ( e.g. at least 20 % or 50 % reduction of the baseline score ) are as yet unclear . We therefore compared the PANSS with simultaneous ratings of Clinical Global Impressions ( CGI ) . METHOD PANSS and CGI ratings at baseline ( n = 4091 ) , and after one , two , four and six weeks of treatment taken from a pooled data base of seven pivotal , multi-center antipsychotic drug trials on olanzapine or amisulpride in patients with exacerbations of schizophrenia were compared using equipercentile linking . RESULTS Being considered " mildly ill " according to the CGI approximately corresponded to a PANSS total score of 58 , " moderately ill " to a PANSS of 75 , " markedly ill " to a PANSS of 95 and severely ill to a PANSS of 116 . To be " minimally improved " according to the CGI score was associated with a mean percentage PANSS reduction of 19 % , 23 % , 26 % and 28 % at weeks 1 , 2 , 4 and 6 , respectively . The corresponding figures for a CGI rating " much improved " were 40 % , 45 % , 51 % and 53 % . CONCLUSIONS The results provide a better framework for underst and ing the clinical meaning of the PANSS total score in drug trials of schizophrenia patients with acute exacerbations . Such studies may ideally use at least a 50 % reduction from baseline cut-off to define response rather than lower thresholds . In treatment resistant population s , however , even a small improvement can be important , so that a 25 % cut-off might be appropriate Abstract . Background : Despite an acknowledgement of the impact of serious mental disorders on informal caregivers , we still know little about how to best help them . The aim of the study was to evaluate the effectiveness of a two-phased carers ’ intervention comprising family sessions followed by relatives ’ groups . This intervention was design ed to be of ‘ intermediate ’ intensity , that is , one lying between brief educational programmes and long-term family psychoeducational treatments . Methods : An exploratory r and omised controlled trial was conducted comparing the experimental support programme with ‘ st and ard ’ care .  All carers of patients with a psychotic disorder from a defined population were approached . Outcome measures were based on a ‘ stress- appraisal -coping ’ model of caregiving . Results : Despite concerted attempts to engage carers , only 42 % participated in the study . The carers ’ programme did not offer any significant advantage on any of the outcome measures : psychological morbidity , negative appraisal , coping or social support . The severity of caregiving difficulties decreased over the study period for the group as a whole . Conclusions : There is still uncertainty about the most effective interventions for carers . Meeting ‘ needs ’ may not improve caregiver distress The differences between two short-term , multifamily group intervention programs for relatives of hospitalized chronic schizophrenics were examined in a nonequivalent comparison group design . The psychoeducational intervention consisted of interactive instructional activities . The support group intervention consisted of nonstructured discussion s. Analysis of covariance on adjusted posttest means indicated a differential treatment effect for depression and satisfaction for the psychoeducational group . The findings suggest that the process of a support group may not be compatible with a short time frame BACKGROUND Relatives of people with psychosis experience high levels of distress and require support .  Family interventions have been shown to be effective in improving outcomes but are difficult to access and not suitable for all relatives . AIMS To assess the feasibility and effectiveness of a supported self-management package for relatives of people with recent-onset psychosis . METHOD A r and omised controlled trial ( n = 103 ) comparing treatment as usual ( TAU ) in early intervention services with TAU plus the Relatives ' Education And Coping Toolkit ( REACT ) intervention ( trial identifier : IS RCT N69299093 ) . RESULTS Compared with TAU only , those receiving the additional REACT intervention showed reduced distress and increased perceived support and perceived ability to cope at 6-month follow-up . CONCLUSIONS The toolkit is a feasible and potentially effective intervention to improve outcomes for relatives . A larger trial is needed to reliably assess the clinical and cost-effectiveness of REACT , and its impact on longer-term outcomes OBJECTIVES To evaluate the effectiveness of a psychoeducation program for Chinese clients with schizophrenia and their family caregivers . METHODS A r and omized controlled trial was conducted . Seventy-three clients with a diagnosis of schizophrenia and their caregivers ( n=73 ) were recruited and r and omized into a study ( n=36 ) and control group ( n=37 ) . Ten psychoeducation sessions were provided to the study group . The outcomes were measured at the baseline , immediately after ( post-1 ) , six months ( post-2 ) , and 12 months after the intervention ( post-3 ) . RESULTS There were significant treatment effects across time for all client outcomes : adherence to medication ( p<0.01 ) , mental status ( p<0.01 ) , and insight into illness ( p<0.01 ) . However , no significant differences were found between groups at the post-3 measures for all client outcomes . For the caregivers , significant group differences were only detected in self-efficacy at the post-1 ( p=0.007 ) and post-2 ( p<0.001 ) measures , the level of satisfaction at the post-1 ( p=0.033 ) and post-2 ( p<0.021 ) measures , and the perception of family burden at the post-2 measures ( p=0.043 ) . CONCLUSION A psychoeducation intervention had positive effects on Chinese clients and their caregivers . However , these effects might not be sustained 12 months after the intervention . PRACTICE IMPLICATION S To substantiate its effects , psychoeducation should be an ongoing intervention , with its outcomes constantly evaluated Background The majority of patients with schizophrenia live with their relatives in Pakistan , thereby families experience a considerable burden . We aim ed to study the impact of psychoeducation on the burden of schizophrenia on the family in a r and omised controlled trial . Methods A total of 108 patients with schizophrenia and their family members from the outpatient department of a teaching hospital in Lahore , Pakistan were r and omised . Both groups received psychotropic drugs but one group received psychoeducation in addition . Family burden was assessed at the time of recruitment and at 6 months post intervention . Results In all , 99 patients and their relatives completed the treatment . There was significant reduction in burden at post-intervention assessment in the psychoeducation group based on intention to treat analysis . Conclusion Family psychoeducation can be an important intervention for patients with schizophrenia in Pakistan Background This study explored the effectiveness of family psycho-education in reducing patients ’ symptoms and on  family caregiver burden . Methods Seventy Iranian out patients with a diagnosis of schizophrenia disorder and their caregivers were r and omly allocated to the experimental ( n = 35 ) or control groups ( n = 35 ) . Patients in the experimental group received antipsychotic drug treatment and a psycho-educational program was arranged for their caregivers . The psycho-educational program consisted of ten 90-min sessions held during five weeks ( two session in each week ) . Each caregiver attended 10 sessions ( in five weeks ) At baseline , immediately after intervention , and one month later . Vali date d tools were used to assess patients ’ clinical status and caregiver burden . Results Compared with the control group , the case group showed significantly reduced symptom severity and caregiver burden both immediately after intervention and one month later . Conclusions These results suggest that even need based short-term psycho-educational intervention for family members of Iranian patients with schizophrenic disorder may improve the outcomes of patients and their families . Trial registration I RCT Number:138809122812 N1 Family members of 55 patients with schizophrenia were r and omly assigned to a psychoeducational support group or to a control group . Support group participants showed greater knowledge of schizophrenia and greater satisfaction with health care services than did control group members . Psychological distress , coping behavior , and family satisfaction did not appear affected by support group participation ; nor were support groups associated with lower rehospitalization rates for patients The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas One hundred eighty-three relatives of people with serious mental illnesses were r and omly assigned to receive individualized consultation or group psychoeducation or were placed on a 9-month wait list . Analysis of variance and multiple regression revealed that the individualized consultation increased the family members ' sense of self-efficacy regarding mentally ill relatives . Group psychoeducation was helpful in increasing self-efficacy of family members who had never participated in a support or advocacy group for relatives of psychiatrically disabled individuals Background Siblings of individuals with first episode psychosis are natural partners to promote service users ’ recovery and are themselves vulnerable to mental ill health due to the negative impact of psychosis within the family . This study aims to develop and undertake a preliminary evaluation of the efficacy of an online multi-component psychoeducational intervention for siblings of individuals with first episode psychosis . The impetus for the intervention arose from siblings ' expressed needs for peer support and information on psychosis , coping and management strategies for common symptoms and ways to promote recovery . Methods / Design The project design draws on the Medical Research Council framework for the design and evaluation of complex interventions . Mixed methods comprising collection of qualitative focus group data , systematic review and expert advisory group consultation are used to develop the theoretical basis for and design of the intervention . This protocol focuses on the modelling and piloting phase which uses a r and omised controlled trial with factorial design to test the efficacy of the intervention . Outcome data on participants ’ mental wellbeing , knowledge , perceived self-efficacy and experiences of caregiving will be assessed at baseline , at end of the intervention ( 10 weeks later ) and at 10 week follow-up . In addition , a post-intervention semi-structured interview with 20 % of the participants will explore their experiences and acceptability of the intervention . Discussion This multi-component online psychoeducational intervention aims to enhance siblings ' knowledge about psychosis and their coping capacity , thus potentially improving their own mental wellbeing and promoting their contribution to service users ’ recovery . The factorial design r and omised controlled trial with a supplementary process evaluation using semi-structured interviews and usage-monitoring will collect preliminary evidence of efficacy , feasibility and acceptability , as well as feedback about the barriers and strategies to using such an innovative re source . The RCT will provide data for estimating the likely effect size of the intervention on outcomes for siblings and inform the development of a definitive future trial . Trial registration Trial registration : IS RCT OBJECTIVE This study examined the use of a uniquely design ed Web site and home computers to deliver online multifamily psychoeducational therapy to persons with schizophrenia and their informal supports ( family and friends ) . Web site usage and outcome benefits are reported . METHODS Thirty-one persons with schizophrenia or schizoaffective disorder and 24 support persons were r and omly assigned to the online intervention ( telehealth ) or treatment as usual ( usual care ) condition . At three , six , and 12 months , interviewer-administered assessment s were conducted with participants . Intention-to-treat analyses compared persons with schizophrenia in the two study conditions on severity of positive symptoms and knowledge of schizophrenia . Support persons in the two study conditions were compared on knowledge of schizophrenia . Each participant 's usage of the Web site was logged . RESULTS Persons with schizophrenia in the telehealth condition had a large and significant reduction in positive symptoms ( p=.042 , d=-.88 ) and a large and significant increase in knowledge of schizophrenia compared with their counterparts in the usual care condition . Support persons in the telehealth condition showed a large and significant increase in knowledge about prognosis compared with those in the usual care condition ( p=.036 , d=1.94 ) . Persons with schizophrenia used the Web site to a much greater extent ( pages viewed and time spent ) than support persons . CONCLUSIONS These findings suggest that online delivery of psychotherapeutic treatment and educational re sources to consumers ' homes has considerable potential to improve consumer well-being and offers several advantages over st and ard clinic-based delivery models OBJECTIVE This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients ' personal and social functioning as well as on relatives ' burden 
    Output:
    
The limited study data we obtained provides no clear good quality evidence to indicate psychoeducation is beneficial for siblings ' wellbeing or for clinical outcomes of people affected by SMI .
More r and omised studies are justified and needed to underst and the role of psychoeducation in addressing siblings ' needs for information and support