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

NCT07545941 | Completed DMC

• 1 other identifier: Faculty of Nursing
• Study Type: interventional
• Target: 53
• Locations: 1 country
• Sites: 1

Brief Summary

This study examined the effects of family psychoeducation program via line application on expressed emotion of family members and medication adherence in patients with first-episode schizophrenia.

Conditions

First- Episode Schizophrenia

Keywords

Mobile -based family psychoeducation; Expressed emotion; Medication adherence; First-episode schizophrenia; Randomized controlled trial

Outcome Measures

Primary Outcomes (1)

• Expressed Emotion

  Expressed Emotion was measured using the Thai Expressed Emotion Scale (TEES), developed by Sunpaveerawong. The instrument consists of 49 items encompassing seven components of expressed emotion. Negative expressed emotion includes Critical Comments (items 1-7), Hostility (items 8-15), Emotional Overinvolvement (items 16-20), and Emotional Under involvement (items 42-49), totaling 28 items. Positive expressed emotion includes Warmth (items 21-27), Positive Remarks (items 28-34), and Emotion Regulation (items 35-41), totaling 21 items.

  From enrollment (week 1) to post treatment at week 8

Secondary Outcomes (1)

• Medication Adherence

  From enrollment (week 1) to post treatment at week 8

Study Arms (2)

control

NO INTERVENTION

Participants in the control group received routine outpatient psychiatric care only. No structured family psychoeducation was provided during the study period.

Mobile based Family Psychoeducation Program

EXPERIMENTAL

Mobile based Family Psychoeducation Program, In addition to routine treatment, a structured 7week Online Psychoeducation Program delivered via the LINE application. The program was developed based on the Vulnerability Stress Model and aimed to reduce expressed emotion among family caregivers and improve medication adherence in patients with first-episode schizophrenia. The intervention consisted of seven video-based sessions, each lasting no more than 10 minutes, delivered weekly over seven consecutive weeks through a private LINE chat. Content covered program orientation, knowledge about schizophrenia, medication management and adherence, stigma and coping strategies, expressed emotion and family communication, stress management, and early warning signs of relapse.

Behavioral: Mobile based family psychoeducation program

Interventions

Mobile based family psychoeducation program BEHAVIORAL

A structured 7week Online Psychoeducation Program delivered via the LINE application. The program was developed based on the Vulnerability Stress Model and aimed to reduce expressed emotion among family caregivers and improve medication adherence in patients with first-episode schizophrenia. The intervention consisted of seven video-based sessions, each lasting no more than 10 minutes, delivered weekly over seven consecutive weeks through a private LINE chat. Content covered program orientation, knowledge about schizophrenia, medication management and adherence, stigma and coping strategies, expressed emotion and family communication, stress management, and early warning signs of relapse.

Mobile based Family Psychoeducation Program

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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
• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Mahidol University: lead

Study Sites (1)

Faculty of Nursing, Mahidol University

Bangkok Noi, Bangkok, 10700, Thailand

Location

Related Publications (1)

• Budiono W, Kantono K, Kristianto FC, Avanti C, Herawati F. Psychoeducation Improved Illness Perception and Expressed Emotion of Family Caregivers of Patients with Schizophrenia. Int J Environ Res Public Health. 2021 Jul 15;18(14):7522. doi: 10.3390/ijerph18147522.

  PMID: 34299972 BACKGROUND

MeSH Terms

Conditions

Medication Adherence

Condition Hierarchy (Ancestors)

Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Yajai Sitthimongkol, PhD

  Faculty of Nursing, Mahidol University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Graduate Student

Model Details: A structured 7week Online Psychoeducation Program delivered via the LINE application. The program was developed based on the Vulnerability Stress Model and aimed to reduce expressed emotion among family caregivers and improve medication adherence in patients with first-episode schizophrenia. The intervention consisted of seven video-based sessions, each lasting no more than 10 minutes, delivered weekly over seven consecutive weeks through a private LINE chat. Content covered program orientation, knowledge about schizophrenia, medication management and adherence, stigma and coping strategies, expressed emotion and family communication, stress management, and early warning signs of relapse.

Study Record Dates

• First Submitted: April 16, 2026
• First Posted: April 22, 2026
• Study Start: May 26, 2025
• Primary Completion: September 14, 2025
• Study Completion: September 14, 2025
• Last Updated: April 27, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TH (1)