The Influence of Family Expressed Emotion on the Course of Schizophrenia in a Sample of Spanish Patients

1992 ◽  
Vol 161 (2) ◽  
pp. 217-222 ◽  
Author(s):  
I. Montero ◽  
M. Gómez-Beneyto ◽  
I. Ruiz ◽  
E. Puche ◽  
A. Adam
Keyword(s):  
Expressed Emotion ◽  
Schizophrenic Patients ◽  
The Relationship

A sample of 60 Spanish schizophrenic patients was studied to ascertain the relationship between their relatives' expressed emotion (EE) and relapse at follow-up. The relatives' EE and patients' relapse were operationalised following Leff & Vaughn's criteria. At nine months a significant association was not found between the relatives' EE and relapse, but this association became significant on reclassifying the relatives' EE scores after decreasing to four points the cut-off point for critical comments. At 24 months no association was found between EE and relapse. There was a tendency for patients who interrupted their medication or who did not work to relapse more frequently, particularly among the high-EE group.

Family Management Programmes for Schizophrenic Patients

1989 ◽  
Vol 155 (S5) ◽  
pp. 112-116 ◽  
Author(s):  
Kurt Hahlweg ◽  
Eli Feinstein ◽  
Ursula Müller ◽  
Matthias Dose
Keyword(s):  
Expressed Emotion ◽  
Causal Role ◽  
Family Management ◽  
New Techniques ◽  
Schizophrenic Psychosis ◽  
Schizophrenic Patients ◽  
Family Variables ◽  
Relationship Of ◽  
The Relationship

Hypotheses on the relationship of schizophrenia and family variables have changed considerably over the last 15 years: whereas speculations on the causal role of familial interaction for the onset of schizophrenic psychosis previously dominated the field of psychological theorising and psychotherapy (Bateson et al, 1956), it was not possible to confirm these theories empirically. In accordance with the research on Expressed Emotion (EE), a shift in emphasis to the influence of family variables on the further course of the illness has taken place. As a consequence, promising new techniques have been developed for the prevention or postponement of relapse.

Expressed emotion and early onset schizophrenia: a one year follow-up

1991 ◽  
Vol 21 (3) ◽  
pp. 675-685 ◽  
Author(s):  
John Stirling ◽  
Digby Tantam ◽  
Philip Thomas ◽  
David Newby ◽  
Linda Montague ◽  
...  
Keyword(s):  
Early Onset ◽  
Expressed Emotion ◽  
Acute Onset ◽  
Work Study ◽  
Early Onset Schizophrenia ◽  
Early Admission ◽  
Elapsed Time ◽  
One Year ◽  
The Relationship

SYNOPSISKey relatives of 33 first or early admission psychotic patients (mainly schizophrenics) were interviewed to determine household levels of expressed emotion (EE). The patients were followed up for 12 months from index admission, during which time 13 (39%) experienced psychotic relapse. There was no association between relapse rate and household EE, but correlations between individual components of EE and pre-morbid measures suggest that level of criticism may be related to less acute onset of index episode, greater elapsed time since first signs of illness, and poor adjustment in the realm of work/study. The results are discussed in the context of continuing uncertainties about the precise nature of the relationship between EE and relapse.

Expressed Emotion and Schizophrenia in Italy

1992 ◽  
Vol 161 (2) ◽  
pp. 223-229 ◽  
Author(s):  
P. Bertrando ◽  
J. Beltz ◽  
C. Bressi ◽  
M. Clerici ◽  
T. Farma ◽  
...  
Keyword(s):  
General Hospital ◽  
Community Service ◽  
Expressed Emotion ◽  
Admission Rate ◽  
Replication Study ◽  
Psychiatric Ward ◽  
Emotional Overinvolvement ◽  
Schizophrenic Patients ◽  
Close Relatives

Forty-two schizophrenic patients and their close relatives took part in an Italian replication study of expressed emotion (EE). The patients were selected from the psychiatric ward of a general hospital in Milan and were subsequently followed up for nine months. All patients attended a community service clinic as out-patients, and all but one were prescribed neuroleptics for the duration of the study. Relatives were assigned to the high-EE group if they scored 4 or 5 on the emotional overinvolvement (EOI) scale, or showed hostility, or made six or more critical comments. On this basis, 18 (42%) families were rated as low EE and 24 (57%) as high EE. At follow-up, the admission rate for the 9-month period was significantly higher for the high-EE group (P<0.05). Furthermore, significantly fewer patients were readmitted from families showing high warmth (P<0.05). The presence of high warmth appeared to be associated with a lower admission rate, even in high-EE families.

Expressed emotion and schizophrenia: the ontogeny of EE during an 18-month follow-up

1993 ◽  
Vol 23 (3) ◽  
pp. 771-778 ◽  
Author(s):  
J. Stirling ◽  
D. Tantam ◽  
P. Thomas ◽  
D. Newby ◽  
L. Montague ◽  
...  
Keyword(s):  
Expressed Emotion ◽  
Psychiatric Morbidity ◽  
Index Admission ◽  
Initial Assessment ◽  
Early Admission ◽  
Psychiatric Status ◽  
The Relationship ◽  
Interim Period

SynopsisKey relatives of 30 first or early admission psychotic patients (mainly with a diagnosis of schizophrenia) were interviewed (for a second time) 18 months after participating in an initial assessment of expressed emotion (EE). The patients were followed up throughout the interim period, during which time 17 experienced a psychotic relapse. Although there continued to be a negligible association between initial EE rating (established during the index admission) and relapse, a significant association between EE rating at 18 months and psychiatric status of the patient during the follow-up period emerged. Results are discussed in the context of recent interactional theories of the relationship between household EE and psychiatric morbidity.

Levels of Expressed Emotion and Relapse in Depressed Patients

1986 ◽  
Vol 148 (6) ◽  
pp. 642-647 ◽  
Author(s):  
Jill M. Hooley ◽  
John Orley ◽  
John D. Teasdale
Keyword(s):  
Psychiatric Hospital ◽  
Predictive Validity ◽  
Expressed Emotion ◽  
Depressed Patients ◽  
Hospital Patients ◽  
The Relationship

The relationship between spouses' levels of expressed emotion (EE) and relapse was examined in a sample of 39 depressed psychiatric hospital patients. Over a nine-month follow-up, 59% of patients with high-EE spouses relapsed, although no patients living with low-EE spouses did so. The results replicate the association found by Vaughn & Left between EE and depression, and suggest that the EE construct has predictive validity in both schizophrenic and depressed populations.

Relatives' Expressed Emotion and the Course of Schizophrenia in Chandigarh

1990 ◽  
Vol 156 (3) ◽  
pp. 351-356 ◽  
Author(s):  
J. Leff ◽  
N. N. Wig ◽  
H. Bedi ◽  
D. K. Menon ◽  
L. Kuipers ◽  
...  
Keyword(s):  
Expressed Emotion ◽  
Family Members ◽  
The West ◽  
Initial Interview ◽  
Schizophrenic Patients ◽  
One Year ◽  
The One ◽  
First Contact ◽  
Subsequent Relapse

A two-year follow-up was conducted of a subsample of the Chandigarh cohort of first-contact schizophrenic patients from the WHO Determinants of Outcome project. The patients were those living with family members who had been interviewed initially to determine their levels of expressed emotion (EE). The interview was repeated for 74% of the relatives at one-year follow-up. A dramatic reduction had occurred in each of the EE components and in the global index. No rural relative was rated as high EE at follow-up. Of the patients included in the one-year follow-up, 86% were followed for two years. In contrast to the one-year findings, the global EE index at initial interview did not predict relapse of schizophrenia over the subsequent two years. However, there was a significant association between initial hostility and subsequent relapse. The better outcome of this cohort of schizophrenic patients compared with samples from the West is partly attributable to tolerance and acceptance by family members.

An overview of family interventions and relapse on schizophrenia: meta-analysis of research findings

1994 ◽  
Vol 24 (3) ◽  
pp. 565-578 ◽  
Author(s):  
Jair De Jesus Mari ◽  
David L. Streiner
Keyword(s):  
Expressed Emotion ◽  
Data Extraction ◽  
Meta Analysis ◽  
Control Group ◽  
Family Interventions ◽  
Medline Search ◽  
Number Of Patients ◽  
Schizophrenic Patients ◽  
Experimental Group

SynopsisThe purpose of this overview is to appraise the studies on the efficacy and effectiveness of family interventions in decreasing relapse in schizophrenic patients. The studies were identified by means of a computerized MEDLINE search, and the scanning of review articles and the reference lists of the primary articles identified. More than 300 citations were reviewed, and the potentially relevant articles revealed six randomized controlled trials that were included in this meta-analysis. The criteria for selecting potential studies as well as for the meta-analysis were tested by means of an inter-rater reliability check that showed a good agreement between two independent raters (K = 0·83, and K = 0·82, respectively). There were independent assessments of the quality of the studies selected, and data extraction comprised a descriptive information of the study population, the types of interventions, and the relevant outcome measurements. The total number of patients included in the six trials was 350 (181 in the control group and 169 in the experimental group). Regarding the decrease of relapse in the experimental group, the pooled odds ratios and their 95% confidence intervals were: 0·30 (0·06, 0·71) for six months; 0·22 (0·09, 0·37) for nine months; and 0·17 (0·10, 0·35) for the 2-year follow-up. Two to five patients needed to be treated to avert one episode of relapse in a nine-month follow-up. The changes in Expressed Emotion status between experimental and control group combining nine months and one year follow-ups were shown to be marginally significant (P < 0·06), in favour of the experimental group. Emotional over-involvement was also marginally significant (P < 0·07), and there was no statistical difference in the distribution of criticism and hostility. In addition, the experimental group showed a significant increase with drug compliance and a reduction in hospitalization over time. These findings are discussed in light of the potential ingredients in the efficacy of family interventions by focusing on the limitations of using relapse as primary outcome in the assessment of efficacy trials with schizophrenic patients.

Relationship between family attitudes measured by the Semantic Differential and relapse in schizophrenia: a 2 year follow-up prospective study

1995 ◽  
Vol 25 (2) ◽  
pp. 365-371 ◽  
Author(s):  
Manuel Girón ◽  
Manuel Gomez-Beneyto
Keyword(s):  
Prospective Study ◽  
Negative Symptoms ◽  
Predictive Power ◽  
Treatment Compliance ◽  
Semantic Differential ◽  
Family Attitudes ◽  
Schizophrenic Patients ◽  
A Prospective Study ◽  
The Relationship

SynopsisA prospective study was carried out to investigate the relationship between family attitudes and relapse in a cohort of 80 schizophrenic patients followed up for 2 years. A significant relationship was found between attitudes as measured by means of a semantic differential during hospitalization and later relapse. Lack of treatment compliance, negative symptoms, unemployment and poor pre-morbid adjustment were also associated with relapse. In a multivariate analysis some of these variables changed their predictive power but the association between attitudes and relapse was maintained.

A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients: Two Year Follow-up

1985 ◽  
Vol 146 (6) ◽  
pp. 594-600 ◽  
Author(s):  
Julian Leff ◽  
Liz Kuipers ◽  
Ruth Berkowitz ◽  
David Sturgeon
Keyword(s):  
Relapse Rate ◽  
Antipsychotic Medication ◽  
Expressed Emotion ◽  
Controlled Trial ◽  
Social Contact ◽  
Social Intervention ◽  
Face To Face ◽  
The Social ◽  
Schizophrenic Patients

SummaryThe two-year follow-up results are reported of a trial of social intervention in families of schizophrenic patients in high social contact with high-expressed emotion (EE) relatives. For those patients who remained on antipsychotic medication throughout the two years, the social intervention significantly reduced the relapse rate. In those experimental families where relatives' EE and/or face-to-face contact was lowered, the relapse rate was 14%, compared with 78% for control patients on regular medication (P = 0.02).

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