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Expressed emotion and depression. A longitudinal study

H Hayhurst1, Z Cooper, E S Paykel

  • 1Department of Psychiatry, University of Cambridge.

The British Journal of Psychiatry : the Journal of Mental Science
|February 17, 1998
PubMed
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Criticism from relatives during acute depression does not predict relapse. Consistently uncritical partners are linked to full recovery in depressed patients, while persistent criticism may indicate residual symptoms.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Family Studies

Background:

  • Previous research indicates that criticism from relatives during acute depressive illness predicts relapse over nine months.
  • However, the longitudinal course of criticism and its relationship with the evolving course of depression in patients have not been thoroughly investigated.

Purpose of the Study:

  • To examine the temporal relationship between criticism from relatives and the course of depressive illness over approximately one year.
  • To investigate whether criticism predicts remission or relapse in depressed patients.

Main Methods:

  • A longitudinal study involving 39 depressed patients and their partners, interviewed separately at three-monthly intervals for about one year.
  • Illness severity was assessed using Research Diagnostic Criteria and the Hamilton Depression Rating Scale.

Related Experiment Videos

  • Criticism was measured using the Camberwell Family Interview.

    • Main Results:

    • Criticism during the acute phase of depression did not predict remission or subsequent relapse.
    • Patients who achieved full recovery (with or without later relapse) had partners who were either consistently uncritical or critical only at the initial assessment.
    • Patients experiencing residual symptoms during remission had partners who exhibited more persistent criticism.

    Conclusions:

    • The precise nature of the association between criticism and depression remains unclear, though continuing criticism appears linked to ongoing depressive symptoms.
    • Relatives' comprehension of the illness may play a mediating role between criticism levels and the trajectory of depression.