The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population

Abstract

BackgroundAn appropriate understanding of the association between high-Expressed Emotion (EE) in family members of people with schizophrenia, patients’ and relatives’ correlates is needed to improve adaptation of psychoeducational interventions in diverse cultures. The aim of this study was to test the hypothesis that relatives designated as high EE would report higher subjective burden of care, and would be associated with objective variables that indicate greater illness severity i.e. number of previous hospitalizations and duration of illness.MethodsWe performed secondary analyses of baseline data from a randomized controlled trial conducted in Italy.ResultsHigh-EE relatives reported more subjective burden of care in disturbed behaviours and adverse effects areas, but did not perceive more deficits in social role performances. As regards illness severity characteristics, neither the number of previous hospital admissions nor the duration of illness was associated with high-EE. However, patients’ previous psychosocial functioning, as measured by educational attainments, seems to protect the relative from high-EE status.ConclusionThere is a need for cross-cultural comparisons of the subjective experience of distress and burden among high EE carers as a target for intervention, aimed at reducing family stress as much as improving patient outcomes.

Burnout in caregivers of patients with schizophrenia

“…It was found that perceived social support and getting professional support were important determinants of burnout in previous studies (32,33). Perceived social support was associated with all burnout dimensions in our study.…”

Efficacy of psychoeducational family intervention for bipolar I disorder: A controlled, multicentric, real-world study

“…In fact, the family may play a significant role in bipolar disorder, similar to schizophrenia (Magliano et al, 2006a(Magliano et al, , 2006b) and major depression (Luciano et al, 2012a), in which living in a dysfunctional family is associated with more frequent relapses and hospitalizations, lack of compliance, and a worse social functioning (Carrà et al, 2012;Fiorillo et al, 2013a;Viana et al, 2013). Moreover, in bipolar disorders, high levels of family burden can have a detrimental effect not only on patients' long-term outcome, but also on caregivers' quality of life and well-being (Ogilvie et al, 2005;Steele et al, 2010;Pompili et al, 2014).…”

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia—A Longitudinal Study

“…18,19 Relapse rates 20 and duration of untreated first-episode psychosis are associated with family conditions like perceived criticism 21 and emotional over-involvement, both aspects of the high EE concept. 25,26 Nevertheless, general literature on family atmosphere 22,23 suggests that EE is often 24 but not always 25 related to higher relapse rates and criticism is a better predictor than the EE composite score in the long run.…”