Life events, relatives' Expressed Emotion and maintenance neuroleptics in schizophrenic relapse

Abstract

SYNOPSIS Data from two studies, one naturalistic and the other a controlled trial, were analysed to clarify the relationships between independent life events, Expressed Emotion of a key relative, maintenance neuroleptics and the relapse of schizophrenia. It was found that patients in the community who are unprotected by medication are vulnerable either to acute stress in the form of life events or to chronic stress in the form of living with a high Expressed Emotion relative. Patients on regular medication are protected against one or other stress, but are very likely to relapse if the two forms of stress occur together. A model of schizophrenic susceptibility to environmental stress is constructed to incorporate these observations.

Abandoning the concept of ‘schizophrenia‘: Some implications of validity arguments for psychological research into psychotic phenomena

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“…Critical attitudes from caregivers can lead to both non-adherence and relapses despite continued treatment [101], while family support has the opposite effect [102]. The effects of such factors may be additive: patients receiving maintenance medication may relapse if exposed to a combination of negative caregiver attitudes and ongoing life stress [103].…”

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