Reducing Caregiver Depression in Schizophrenia: A Retrospective Quasi-Experimental Study of a CBT-Based Psychoeducational Program Using a Waiting-Period Control

Caregivers of individuals with schizophrenia face substantial psychological burden, with higher depression rates than the general population. Profamille, a multifamily psychoeducational program offered in France since 1993 and regularly updated, integrates cognitive-behavioral strategies to improve caregivers’ mood and coping skills. Mood was assessed using CES-D-20 and PHQ-9 scales, allowing a distinction between major depressive disorder and other forms of depression, referred to here as subclinical depression. A systematic waiting period between inclusion and program start enables caregivers to prepare and fully engage. We conducted a retrospective analysis of all French groups participating in version V3.2 (2011–2019). Using archival data, we randomly selected two subsamples of participants: a pseudo-control group (i.e., waiting-period control group; N = 1,116) and an active intervention group (N = 1,117). At baseline, in both groups, slightly more than half of caregivers had CES-D scores >16, indicating clinically relevant depressive symptoms. Profamille significantly improved caregivers’ mood: 29% of initially Depressed participants became Non-depressed in the active group versus 8% in controls, and 53% of participants with subclinical depression became Non-depressed versus 25% in controls. Exploratory subgroup analyses suggested a consistent pattern of intervention effects across caregiver and patient characteristics. Non-depressed caregivers maintained stable mood over time, with a trend toward preventive effects compared to the waiting period group. These findings, based on a large retrospective sample with an acceptable missing data rate (12.3%), support the effectiveness, sustainability, and acceptability of Profamille, highlighting its potential to improve caregiver well-being across diverse clinical and demographic contexts.