Expressed emotion and relapse rates in schizophrenic patients

1992 ◽  
Vol 6 (2) ◽  
pp. 172-173
Author(s):  
R. Cohen ◽  
T. Niedermeier ◽  
H. Watzl
Keyword(s):  
Expressed Emotion ◽  
Schizophrenic Patients ◽  
Relapse Rates

The Community Management of Schizophrenia

1988 ◽  
Vol 153 (4) ◽  
pp. 532-542 ◽  
Author(s):  
Nicholas Tarrier ◽  
Christine Barrowclough ◽  
Christine Vaughn ◽  
J. S. Bamrah ◽  
Kathleen Porceddu ◽  
...  
Keyword(s):  
Expressed Emotion ◽  
Psychiatric Services ◽  
Community Management ◽  
Behavioural Intervention ◽  
Partial Support ◽  
Routine Treatment ◽  
Treatment Groups ◽  
Schizophrenic Patients ◽  
Relapse Rates

Schizophrenic patients were recruited into a trial of a prophylactic behavioural intervention with families. Families with at least one high Expressed Emotion (EE) relative were randomly allocated to one of four intervention groups: Behavioural Intervention Enactive; Behavioural Intervention Symbolic; Education Only; Routine Treatment. Patients from low-EE families were randomly allocated to two groups: Education Only or Routine Treatment. Relapse rates over nine months after discharge were significantly lower for patients in the two Behavioural Intervention, compared with Education Only and Routine Treatment groups. There was little difference between the two low-EE groups. Patients returning to high-EE relatives showed significantly higher relapse rates than those returning to low-EE relatives, in groups not receiving active intervention. Changes from high to low EE occurred in the Behavioural Intervention groups, and similar although less extensive changes occurred in the Education Only and Routine Treatment groups. Changes in criticism and marked emotional over-involvement (EOI) occurred generally in high-EE groups but were larger in magnitude in the Enactive and Symbolic groups. Reduction of hostility only occurred in the Behavioural Intervention groups. These results give partial support for the causal role of EE in relapse. There were no significant differences between the groups with respect to contact with the psychiatric services or medication.

Psychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives: A Follow-up Study

1984 ◽  
Vol 145 (1) ◽  
pp. 62-69 ◽  
Author(s):  
David Sturgeon ◽  
Graham Turpin ◽  
Liz Kuipers ◽  
Ruth Berkowitz ◽  
Julian Leff
Keyword(s):  
Skin Conductance Response ◽  
Expressed Emotion ◽  
Social Intervention ◽  
Psychophysiological Responses ◽  
Social Interventions ◽  
Follow Up Study ◽  
Schizophrenic Patients ◽  
Experimental Group ◽  
Relapse Rates

SummaryMeasurements of skin conductance response frequencies (SCRf) were obtained from 30 acutely ill schizophrenic patients during a standardised videotaped interview, conducted with the patient's key relative present. Significant differences in SCRf's were demonstrated between patients whose relatives had high and low Expressed Emotion (EE) respectively. Patients at high risk of relapse were allocated either to a control or an experimental group, the latter being offered a number of social interventions in order to reduce the relative's EE and/or contact with the patient. Follow-up measurements were obtained on 19 patients nine months after discharge. Although social intervention was highly successful in reducing relapse rates, its effects did not appear to be directly mediated via SCRf, which was found to be independently related to relapse.

The Salford Family Intervention Project: Relapse Rates of Schizophrenia at Five and Eight Years

1994 ◽  
Vol 165 (6) ◽  
pp. 829-832 ◽  
Author(s):  
Nicholas Tarrier ◽  
Christine Barrowclough ◽  
Kathleen Porceddu ◽  
Elizabeth Fitzpatrick
Keyword(s):  
Predictive Power ◽  
Expressed Emotion ◽  
Intervention Group ◽  
Family Intervention ◽  
Control Group ◽  
Long Term Effects ◽  
The Family ◽  
Schizophrenic Patients ◽  
Relapse Rates

BackgroundThis study assessed the long-term effects of family intervention on schizophrenic relapse.MethodForty schizophrenic patients who had participated in a family intervention trial and who had not experienced relapse at two years after discharge from the index admission were traced through case notes and hospital records. The percentage of patients experiencing a relapse was estimated for patients in the family intervention group, the high-EE control group, and the low-EE control group, at five years and eight years after discharge.ResultsThere were significantly fewer relapses in the family intervention group than in the high-EE control group at both five years and eight years. The number of relapses in the low-EE control group was lower than in the high-EE control group, but this just failed to reach significance.ConclusionsThe benefit of family intervention and the predictive power of EE are sustained over eight years. Expressed emotion (EE) has remained a remarkably robust predictor of relapse in schizophrenia. Kavanagh (1992) cited 20 out of 23 prospective studies that showed patients who returned to live with high-EE relatives had higher relapse rates over 9–12 months after discharge than did patients returning to live with low-EE relatives. Seventeen of these studies reported this difference to be significant.British Journal of Psychiatry (1994),165, 829–832

Appraisal, psychological adjustment and expressed emotion in relatives of patients suffering from schizophrenia

1997 ◽  
Vol 171 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Christine Barrowclough ◽  
Michael Parle
Keyword(s):  
Expressed Emotion ◽  
Symptom Control ◽  
Well Being ◽  
Primary Appraisal ◽  
Coping Theory ◽  
Secondary Appraisal ◽  
Multivariate Relationships ◽  
Schizophrenic Patients ◽  
A Prospective Study ◽  
Appraisal Processes

BackgroundIt is argued that coping theory may be useful in attempting to understand how relatives adapt to the demands of living with a schizophrenia sufferer.MethodIn a prospective study, univariate and multivariate relationships were explored between appraisal variables (appraisal of symptom threat (primary appraisal) and perceived symptom control (secondary appraisal)) and (a) expressed emotion, and (b) psychological distress in relatives of schizophrenic patients. The profile of relatives who showed sustained distress over time was also examined.ResultsThe appraisal variables were found to be related to both the concurrent distress (GHQ scores), EE ratings of relatives at the time of the patients relapse and hospitalisation, as well as the subsequent GHQ scores of relatives when the patient was discharged back home. Relatives who showed sustained distress were likely to show high EE and have a longer caring history.ConclusionsThe study gives some support to the theory that appraisal processes underlie how relatives react to having a family member with schizophrenia, and may have implications both for identifying those at risk of poor adaptation, and for understanding strategies that improve well-being.

The Nithsdale Schizophrenia Surveys. XI: Relatives' Expressed Emotion

1993 ◽  
Vol 162 (3) ◽  
pp. 393-397 ◽  
Author(s):  
R. G. McCreadie ◽  
L. J. Robertson ◽  
D. J. Hall ◽  
I. Berry
Keyword(s):  
Expressed Emotion ◽  
The Third ◽  
Schizophrenic Patients ◽  
Over Time

The level of expressed emotion (EE) in 32 relationships between relatives and schizophrenic patients was assessed on three separate occasions over five years. EE was high on all three occasions in 25% of relatives, low on all three in 38%, and fluctuating in 38%; that is, in the majority of relatives (63%) the level of EE was stable over time. Three relatives who had previously shown high EE had evidence of dementia at the time of the third assessment, and showed low EE. Fourteen patients relapsed at least once over five years; patients who relapsed were evenly spread throughout those living in a home in which EE was consistently high, consistently low, or fluctuating. However, patients living in low-EE homes who did relapse did so significantly less often than those who relapsed and were living in homes in which EE was high or fluctuating. At the time of relapse, EE was not consistently high, and some patients in consistently high-EE homes did not relapse at all over five years.

scholarly journals Factors associated with relapse of schizophrenia

2018 ◽  
Vol 29 (2) ◽  
pp. 59-63
Author(s):  
AKM Akramul Haque ◽  
AHM Kazi Mostofa Kamal ◽  
Zinat De Laila ◽  
Luna Laila ◽  
Helal Uddin Ahmed ◽  
...  
Keyword(s):  
Life Events ◽  
Expressed Emotion ◽  
Stressful Life Events ◽  
Economic Status ◽  
Cross Sectional Study ◽  
High Rate ◽  
Stressful Life ◽  
Cross Sectional ◽  
Significant Difference ◽  
Schizophrenic Patients

Schizophrenia is a chronic psychiatric illness with high rate of relapse which is commonly associated with noncompliance of medicine, as well as stress and high expressed emotions. The objective of the study was to determine the factors of relapse among the schizophrenic patients attending in outpatient departments of three tertiary level psychiatric facilities in Bangladesh. This was a cross sectional study conducted from July, 2001 to June, 2002. Two hundred patients including both relapse and nonrelapse cases of schizophrenia and their key relatives were included by purposive sampling. The results showed no statistically significant difference in terms of relapse with age, sex, religion, residence, occupation and level of education (p>0.05), but statistically significant difference was found with marital status and economic status (p<0.01). The proportion of non-compliance was found to be 80% and 14%, of high expressed emotion was 17% and 2% and of the occurrence of stressful life events was 10% and 1% in relapse and non-relapse cases respectively which were statistically significant (p<0.001). The study indicated that stressful life events, high expressed emotion, and noncompliance with medication had a role in schizophrenic patients for its relapse.Bang J Psychiatry December 2015; 29(2): 59-63

A Trial of Family Therapy v. a Relatives Group for Schizophrenia

1989 ◽  
Vol 154 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Julian Leff ◽  
Ruth Berkowitz ◽  
Naomi Shavit ◽  
Angus Strachan ◽  
Ilana Glass ◽  
...  
Keyword(s):  
Family Therapy ◽  
Relapse Rate ◽  
Expressed Emotion ◽  
Cost Effective ◽  
Or Education ◽  
Face To Face ◽  
Social Interventions ◽  
The Family ◽  
Schizophrenic Patients ◽  
Therapy Sessions

Schizophrenic patients living in high contact with relatives having high expressed emotion (EE) were recruited for a trial of social interventions. The patients were maintained on neuroleptic medication, while their families were randomly assigned to education plus family therapy or education plus a relatives group. Eleven out of 12 families accepted family therapy in the home, whereas only six out of 11 families were compliant with the relatives group. Non-compliance was associated with a poorer outcome for the patients in terms of the relapse rate. The relapse rate over nine months in the family therapy stream was 8%, while that in compliant families in the relatives group stream was 17%. Patients' social functioning showed small, non-significant, gains. The data from the current trial were compared with data from a previous trial. The lowering of the relapse rate in schizophrenia appears to be mediated by reductions in relatives' EE and/or face-to-face contact, and is not explained by better compliance with medication. Reduction in EE and/or contact was associated with a minuscule relapse rate (5%). Very little change occurred in families who were non-compliant with the relatives group. On the basis of these findings, we recommend that the most cost-effective procedure is to establish relatives groups in conjunction with family education and one or more initial family therapy sessions in the home. It is particularly important to offer home visits to families who are unable to or refuse to attend the relatives groups.

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 Components in Families of Schizophrenic Patients in Japan

1995 ◽  
Vol 24 (2) ◽  
pp. 38-49 ◽  
Author(s):  
Yoshio Mino ◽  
Shuichi Tanaka ◽  
Shimpei Inoue ◽  
Toshihide Tsuda ◽  
Aklra Babazono ◽  
...  
Keyword(s):  
Expressed Emotion ◽  
Schizophrenic Patients

Psychophysiological Assessment of Expressed Emotion in Schizophrenia: A Case Example

1984 ◽  
Vol 145 (2) ◽  
pp. 197-200 ◽  
Author(s):  
Nicholas Tarrier ◽  
Christine Barrowclough
Keyword(s):  
Spontaneous Activity ◽  
Skin Conductance ◽  
Expressed Emotion ◽  
Skin Conductance Level ◽  
Personal Distress ◽  
Psychophysiological Response ◽  
Psychophysiological Assessment ◽  
Schizophrenic Patients ◽  
Case Assessment ◽  
Conductance Level

SummaryPrevious research has demonstrated a different psychophysiological response of schizophrenic patients depending on whether their key relative was rated high or low on Expressed Emotion (EE). A case assessment is described in which a young man suffering from schizophrenia, who lived with both a high EE and a low EE parent, was tested psychophysiologically in their presence using an ABAC design. The patient demonstrated a significantly higher amount of spontaneous activity in skin conductance level when the high EE parent was present. The high EE parent also demonstrated a greater perceived inability to cope, and a higher level of personal distress.

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