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

Abstract

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.

Preventing the Entrenchment of High Expressed Emotion in First Episode Psychosis: Early Developmental Attachment Pathways

“…Bentsen et al found that anxiety and depression were more prevalent in households where there are high levels of EOI displayed [13]. Stirling et al, looking at a first-episode psychosis sample, contradict many of the previous findings concerning the association of high EE with relapse rates, but are in agreement with a model that takes reactive components of the patient/ illness/relative dynamic into account [14,15]. They found that a very large proportion of their high EE group reached threshold in EOI (14/16) at index but this was greatly reduced by follow up.…”

Preventing the entrenchment of high expressed emotion in first episode psychosis: early developmental attachment pathways

“…Bentsen et al found that anxiety and depression were more prevalent in households where there are high levels of EOI displayed [13]. Stirling et al , looking at a first‐episode psychosis sample, contradict many of the previous findings concerning the association of high EE with relapse rates, but are in agreement with a model that takes reactive components of the patient/ illness/relative dynamic into account [14,15]. They found that a very large proportion of their high EE group reached threshold in EOI (14/16) at index but this was greatly reduced by follow up.…”

Impaired family functioning in psychosis and its relevance to relapse: a two-year follow-up study

“…Recently there has been some controversy about the predictive efficacy of EE in patients experiencing their first episode of psychosis (FEP) with some studies reporting either weak [14][15][16] or no effect of EE on patient relapse [17,18]. Although the majority of studies treated EE as a unitary construct, some attempted to determine the differential predictive power of its two components -CC and EOI [14,18,19]. High EE is usually associated with high levels of CC, which has been found to make a greater contribution to relapse [3,12,[19][20][21][22][23].…”