The relationship between relative's Expressed Emotion and schizophrenic relapse: an Australian replication

Area of Science:

• Psychiatry
• Clinical Psychology
• Social Determinants of Health

Background:

• High Expressed Emotion (EE) in households has been linked to relapse in individuals with schizophrenia.
• Previous studies have yielded conflicting results regarding the association between EE and relapse rates.

Purpose of the Study:

• To investigate the predictive association between household Expressed Emotion (EE) status and schizophrenic relapse in Sydney, Australia.
• To identify specific patient subgroups and environmental factors that moderate the EE-relapse relationship.

Main Methods:

• A predictive study design was employed in Sydney, Australia.
• Expressed Emotion (EE) status of the patient's household was assessed upon discharge.
• Schizophrenic relapse and re-hospitalisation rates were tracked over time.
• Discriminant function analysis was used to identify key predictors of relapse.

Main Results:

• A significant association was found between returning to a high EE household and increased rates of re-hospitalisation and relapse.
• The EE-relapse association was significant for patients not on medication, males, and those with high family contact.
• Decline in occupational status and frequent critical comments from relatives were the strongest predictors of relapse.

Conclusions:

• Household Expressed Emotion (EE) is a significant predictor of schizophrenic relapse and re-hospitalisation.
• Specific patient characteristics (male, not on medication, high family contact) and environmental factors (critical comments, occupational decline) moderate this association.
• Findings support the majority of published literature on EE and relapse, contrasting with some recent negative reports.