Correlates of expressed emotions as perceived by patients with bipolar disorder

To evaluate expressed emotions (EEs) as perceived by the patients and its correlates among patients with bipolar disorder (BD).

One hundred patients diagnosed with BD were assessed on the Perceived Criticism Measure (PCM), Family emotional involvement and criticism scale (FEICS), Brief dyadic scale for expressed emotions (BDSEE) and Vulnerability for abuse screening scale (VASS) to assess EE and possible abuse by the caregivers. Caregivers were evaluated on family burden interview schedule and family coping questionnaire.

Longer duration of illness (Pearson's correlation coefficient: -0.335; p = .001***) and longer duration of treatment (Pearson's correlation coefficient: -0.317; p = .001***) were associated with significantly lower perceived criticism as assessed by FEICS. Higher use of coping mechanisms such as coercion, avoidance and resignation by caregivers were associated with the higher perception of EE, whereas the use of coping mechanisms such as information seeking, communication, and social involvement by the caregivers was associated with the perception of lower EE among the patients. Higher caregiver burden was associated with a higher perception of the EE by the patients. Higher perception of abuse by the patients was associated with higher EE.

Present study suggests that higher use of maladaptive coping, caregiver burden, and abuse has a significant impact on the EE. Accordingly, psychosocial interventions need to focus on caregivers to reduce EE.