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

Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Simos, Panagiotis G.; Lionis, Christos; Vgontzas, Alexandros N.

doi:10.1016/j.comppsych.2015.06.006

Cited by 39 publications

(29 citation statements)

References 68 publications

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“…The confirmative results were congruent with previous research findings suggesting poor family function and low quality of life in patients with these two spectra of chronic psychiatric disorders (4,6,7,15,17,19).…”

Section: Discussionsupporting

confidence: 82%

“…For example, research has shown that high levels of excitement expressing (high criticism / high emotional involvement) in families of patients with depression, schizophrenia, and bipolar disorder are associated with a possibility of relapse and frequent hospitalization in these patients (1,2). Other researches also indicated that the disordered function of the family of patients with psychotic and bipolar disorders is related to high frequent recurrence (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Family Function and Quality of Life in Patients with Schizophrenia and Bipolar Spectrum Disorders: A Patient-Centered Study

Tabaee

Abbasi

Nejad

et al. 2018

Ann Mil Health Sci Res

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Background: The purpose of the study was to investigate and compare the family function and quality of life in patients with schizophrenia and bipolar spectrum disorders. Methods: A sample included 52 patients with schizophrenia and 58 patients with bipolar spectrum disorders that referred to Sahamie hospital were selected through convenience sampling method. They were asked to answer the family assessment device and quality of life questionnaire. Data were analyzed by independent t-test statistics in SPSS. Results: Results showed that the two groups have no significant difference in family function and quality of life. Patients with schizophrenia spectrum disorders obtained the lowest score in the behavioral control and roles subscales of FAD and patients with bipolar spectrum disorders obtained the lowest score in the behavioral control and problem solving of it. Additionally, patients with schizophrenia spectrum obtained the lowest score in the physical and social relations dimensions of quality of life inventory. The ones with bipolar spectrum obtained the lowest score in the social relations, physical, and psychological dimensions of it. Conclusions: These findings confirm the results of previous studies that showed patients with schizophrenia and bipolar spectrum disorder had family dysfunction and bad quality of life. It is important to pay attention to these factors during assessment, measurement, and implementation of treatment strategies.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Family Function and Quality of Life in Patients with Schizophrenia and Bipolar Spectrum Disorders: A Patient-Centered Study

Tabaee

Abbasi

Nejad

et al. 2018

Ann Mil Health Sci Res

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show abstract

“…According to a study carried out in China, developing countries present lower levels of expressed emotion (8) . Another study carried out in Europe demonstrated that in the United Kingdom patients that live in homes with high levels of EOI have higher relapse rates in a 9-month period (1) . However, samples analyzed in other European countries do not show a relationship between EOI and relapses in schizophrenia (8,24) .…”

Section: Discussionmentioning

confidence: 99%

“…Among the reasons for psychiatric relapses are stress, the appearance of comorbidities and failings in drug treatment. There is research that points out a diathesis-stress model of psychosis, in which the stressful environment, including stress in intrafamily relationships, interacts with biological factors, triggering the disease and recurrence of the symptoms (1) . Regarding comorbidities, schizophrenia patients may present a series of comorbidities during their lives (14) .…”

Section: Discussionmentioning

confidence: 99%

“…EE reflects the extent to which family members close to a patient express critical, hostile and emotionally over-involved attitudes or warmth when talking about the patient (1) . The main components of EE are critical comments (CC), which are related to negative judgment of patient conduct; hostility (H), related to the negative concept of the patient as a person; and emotional overinvolvement (EOI), which refers to feelings or attitudes, to despair, to self-sacrifice and to overprotection of the patient on the part of the family members.…”

Section: Introductionmentioning

confidence: 99%

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Emoção expressa de familiares e recaídas psiquiátricas de pacientes com diagnóstico de esquizofrenia

Zanetti

Vedana

Gherardi‐Donato

et al. 2018

Rev. esc. enferm. USP

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Objective: Assess the relationship between psychiatric relapses of patients with a diagnosis of schizophrenia, the levels of expressed emotion among their relatives and related factors. Method: Prospective study carried out at a mental health outpatient clinic and two Psychosocial Care Centers, with patients and relatives responding to the Family Questionnaire -Brazilian Portuguese Version, a form containing socio-demographic and clinical variables and a structured script to assess relapses. A logistic regression model was used for the analysis. Results: A total of 89 dyads participated in the study. Of the patients investigated, 31% presented relapses and, among the relatives, 68% presented elevated levels of expressed emotion. The relationship between expressed emotion and the relapses was not significant. The logistic regression analysis demonstrated that when there were a higher number of hospital admissions in the two years preceding the study, the chance of the patient relapsing in the 24-month period is 1.34. Conclusion: Expressed emotion was insufficient to predict relapses. Thus, a relapse should be understood as a multifactorial phenomenon. These results provide support for interventions and investigations on the multiple factors involved in the evolution of schizophrenia patients in follow-up at community-based health services. DESCRIPTORS INTRODUCTIONThe concept of Expressed Emotion (EE) has long been used to investigate the family environment of patients with mental disorders. EE reflects the extent to which family members close to a patient express critical, hostile and emotionally over-involved attitudes or warmth when talking about the patient (1) . The main components of EE are critical comments (CC), which are related to negative judgment of patient conduct; hostility (H), related to the negative concept of the patient as a person; and emotional overinvolvement (EOI), which refers to feelings or attitudes, to despair, to self-sacrifice and to overprotection of the patient on the part of the family members. It is worth highlighting that hostility overlaps with critical comments. The family may be classified as having high EE if the family member that spends most of the time with the patient presents one or more of these components (2)(3) . Studies show that EE is a strong predictor of psychiatric relapses in schizophrenic patients, in different social and cultural contexts (4)(5) . A meta-analysis identified 27 articles reporting EE and psychiatric relapses in schizophrenia patients. These studies confirmed that EE is a good predictor of schizophrenia relapses, especially in patients in the most chronic phase of the disease (6) . Recent prospective studies have shown that patients with schizophrenia living with families with high levels of EE have higher chances of suffering relapses when compared to those that live in family settings with low EE (7)(8) .Relapses are defined by the exacerbation of symptoms related to the diagnosis of schizophrenia in patients with a stable condition (7)...

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Family environmental factors in at‐risk mental states for psychosis

Hinojosa-Marqués

Domínguez-Mártínez²,

Barrantes‐Vidal

2021

Clin Psychology and Psychoth

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The family environment represents an important psychosocial factor that impacts psychosis prognosis, but little is known about its effect on the at-risk stages of psychosis. This study presents a comprehensive review and summarizes the state of the art of study on the wide range of family factors related to family functioning in the At-Risk Mental State (ARMS) for psychosis, as well as family interventions in ARMS individuals. Publications were retrieved by an extensive search on MEDLINE, Psy-cINFO and SCOPUS (1990SCOPUS ( -2020. Expressed Emotion is the most studied variable in ARMS literature, but there is scarce evidence of the role of other significant family factors at the ARMS stage. Overall, high Expressed Emotion did not appear to be reactive to ARMS patients' poor clinical status. However, initial evidence has suggested that relatives' beliefs about the disorder may play a significant role, either as mediators of these relationships or as predictors of Expressed Emotion. Available literature yet to yield a consistent pattern of findings on the association between Expressed Emotion or other family functioning indicators and negative outcomes, but some longitudinal studies highlight the greater potential for the protective effects of positive family environments at the ARMS stage. Family-based interventions have demonstrated benefits for both ARMS individuals and family dynamics. An increased focus on the impact of the at-risk stage of illness on relatives' mental well-being is required to provide family support based on their needs and to clarify the mechanisms leading to dysfunctional family dynamics during the critical ARMS period.

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

Cited by 39 publications

References 68 publications

Family Function and Quality of Life in Patients with Schizophrenia and Bipolar Spectrum Disorders: A Patient-Centered Study

Family Function and Quality of Life in Patients with Schizophrenia and Bipolar Spectrum Disorders: A Patient-Centered Study

Emoção expressa de familiares e recaídas psiquiátricas de pacientes com diagnóstico de esquizofrenia

Family environmental factors in at‐risk mental states for psychosis

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