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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In view of the strong evidence supporting the hypothesis that high Expressed Emotion of a key relative contributes to relapse in psychiatric patients, methods used in Expressed Emotion research were applied in an investigation of psychiatric disorder in stroke patients receiving hospital based rehabilitation and support. Patient mood in 37 stroke patients was related to the critical attitude of a key relative. Patient depression may also have been associated with severity of dysphasia, but no link was found between patient mood and the other measures of cognitive or physical deficit used in this study. Psychiatric distress in the key relative had a rather different causal basis. Relatives' psychiatric disorders were associated with physical burden, cognitive deficit, and severity of dysphasia. This study suggests that, when the patient is dependent for self-care, rehabilitation-assisted recovery may alleviate relative distress more than patient distress.
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PMID:Social, functional, and neuropsychological determinants of the psychiatric symptoms of stroke patients receiving rehabilitation and living at home. 344 76

The relationship of the Expressed Emotion (EE) and the outcome of 45 major depressive outpatients with DSM-II-R Mood Disorder was investigated for 6 month prospectively. In the non-remission group (n = 19, 42.2%), past history of major depressive episode was significantly high (p < .01), and there were more high-EE relatives (p < .05) than in the remission group (n = 26). Including borderline-EE (b-EE) as high-EE, the patients in the non-remission group were also more likely to live with high-EE relatives (p < .01) than those in the remission group. On the EE profile rated by the Five Minute Speech Sample, high-EE was 13.3% (n = 6). In the high-EE relatives, 3 were rated as emotional over-involvement (EOI), 2 were Critical, and 1 was EOI and Critical. All of b-EE, (15.6%; n = 7) were rated as the b-Critical. On the Critical subscale, the rate of non-remission increased gradually in the response of the level of criticism (from pure low-EE, b-Critical, and to Critical). With the Hayashi's second method of quantification, the level of criticism and past history of depression correlated with six month outcome. These results might indicate the problem of vicious circle around the recurence, criticism of families, and relapse or prolongation of the episode in depression. It was also suggested that a careful psychoeducational family approach focusing to reduce the negative escalation for patients and their families would contribute to the treatment for mood disorder.
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PMID:[Expressed emotion and six-month treatment of outcome of depressive outpatients with mood disorder]. 855 28

The long-term course of major depressive disorder is often accompanied by relapses or chronicity. Since psychosocial factors have been shown to be important predictors for the long-term outcome, psychotherapy along with drug therapy belongs to the standard methods of treatment. In spite of the effectiveness of psychotherapy, only some of the inpatients are treated with outpatient psychotherapy after hospital discharge. Within the framework of the Heidelberg depression study the authors examined what kind of, how many and for how long endogenously depressed patients sought out-patient psychotherapy after an inpatient treatment in a two-year follow-up. During the follow-up one half of patients were treated with outpatient psychotherapy. They were found to be younger, had suffered from more previous episodes, and their personality was more disturbed than those who had not undergone psychotherapy. The Expressed Emotion index did not make any further difference, whereas certain aspects of partnership quality did. The distinction between the two groups of patients is discussed regarding possible selection processes by treatment indication. It is pointed out that research on synergistic cooperation between members of the mental health services is highly desirable.
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PMID:[Utilization of ambulatory psychotherapy by patients with endogenous depression after inpatient psychiatric treatment]. 933 34

Long-term treatment of patients with chronic schizophrenias requires integration of many therapeutic approaches, co-operation of several professions, and regard for the views of patients and relatives. This review deals with practical aspects of pharmacotherapy, psychotherapy, cognitive resp. psychological treatments, social resp. milieu therapy, rehabilitation, interventions based on the concept of Expressed Emotions (EE), psychoeducation and work with relatives. Continuous neuroleptic treatment is indispensable in most cases to achieve social integration. Indications for adding on antidepressants, lithium, carbamazepine, benzodiazepines and other drugs are discussed, as well as treatment of negative symptoms, depression and management of treatment-resistant symptoms. Psychotherapy needs to regard the possibilities of the patient. In the context of a stable long-term relationship, the patient is supported in experiencing himself as a subject capable of action. Effectiveness of cognitive treatments to date is limited. The best results are achieved by social skills training. Social therapy, which aims at the improvement of functional aspects of the patient, is of paramount importance. Improved possibilities for work rehabilitation are contrasted by difficulties in financing long-term social rehabilitation. Interventions based on the EE concept are highly effective, but are rarely used. Programs that merely convey information without targeting behaviour modification are ineffective. The functions of facilities of treatment in the community are explained, the integrative role of case-management is stressed.
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PMID:[Long-term treatment of chronic schizophrenia]. 1023 21

Using a longitudinal sample of children, this study examined the relation between maternal Expressed Emotion (EE) and mother-child attachment disorganization at age 6 years. A nonclinical sample of 33 children (at ages 12 months and 18 months) from Berlin, Germany participated with their mothers in Ainsworth's Strange Situation. Thirty-two children were again observed with their mothers at age 6 years in a standard laboratory attachment observation. At the time of the 6-year assessment, maternal EE was assessed based on a Five-Minute Speech Sample. Mothers also completed the Life Events Questionnaire, a measure of family stress, and the Present State Examination, a measure of maternal depression. Maternal Expressed Emotion was significantly linked to mother-child attachment security at age 6 years. Further analyses revealed that High EE was most closely linked to the disorganized attachment pattern at age 6 years, an at-risk attachment pattern that has been associated with intrusive and hostile maternal behavior. The relationship was upheld when other relevant variables, including infant attachment disorganization and a measure of perceived family stress, were simultaneously considered. The study provides independent validation of Expressed Emotion as a measure of relationship quality in early childhood. It also provides a basis for the further investigation of the nature of the relation between maternal Expressed Emotion and attachment disorganization.
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PMID:Maternal expressed emotion related to attachment disorganization in early childhood: a preliminary report. 1107 32

Five Minute Speech Sample Expressed Emotion (FMSS-EE) was examined in families of youth with depressive disorders, nondepressed youth with attention deficit/hyperactivity disorder (ADHD), and community controls screened for the absence of depression and ADHD. Consistent with the hypothesis that FMSS-EE shows some specificity as a risk factor for depression, rates of critical EE were significantly higher among mothers of youth with depression as compared to mothers of nondepressed youth with ADHD, or mothers of controls. When both mothers' and fathers' scores were used to generate family EE ratings, rates of overall EE and critical EE were significantly higher for the depressed group than the control group, but the nondepressed ADHD group did not differ significantly from the other groups. Results support the hypothesis that critical EE in mothers shows some specificity as a risk factor or correlate of depression in youth.
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PMID:Is expressed emotion a specific risk factor for depression or a nonspecific correlate of psychopathology? 1176 Dec 89

We assessed the psychopathology of children and adolescents with Recurrent Abdominal Pain (RAP) and tension-type headaches (TTH), the psychopathology and Expressed Emotion (EE) of their mothers and family functioning. Additionally, we assessed the relationship of negative Life Events (LE) to RAP and headaches. Sixty-nine children and adolescents with either RAP or headaches, and their mothers were examined and compared to controls. Of the children with RAP or headache, 81.6% and 83.9% respectively carried a psychiatric diagnosis, primarily anxiety or depressive disorder, in contrast to 15% of controls. Mothers of patients with RAP showed more symptoms of anger and hostility than controls. Index mothers had higher EE than control mothers. More problems were reported in the families of patients with RAP. Families of patients with headache were similar to those with RAP but differed from controls in terms of behaviour control and general functioning. More negative LE were experienced by both index groups. If psychological intervention is decided for certain children with RAP or TTH, it should address their depression, anxiety, the impact of negative LE and family functioning.
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PMID:Recurrent abdominal pain and headache--psychopathology, life events and family functioning. 1236 70

Our objectives were to determine the extent to which symptoms in the schizophrenia patient and personality in the mother lead to a sense of subjective burden in the mother, and to explain variance in two components of Expressed Emotion. Data on symptom severity (PANSS), mothers' personality (NEO-PI), subjective burden (SBAS), and Expressed Emotion (CFI) were gathered from 41 schizophrenia outpatients and their mothers. Approximately one quarter of the variance in Critical Comments (CCs) and Emotional Overinvolvement (EOI) was explained using path analysis. Mothers' CCs were associated with more severe excitement in the patient, with lower Neuroticism, and greater burden in the mother. Higher EOI was explained by greater Conscientiousness and burden in the mother; patient depression had a weak indirect effect on maternal EOI. These results characterize the high EE mother as low in neuroticism and high in conscientiousness with a particular sensitivity to excitement and depression in the patient.
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PMID:Determinants of expressed emotion in mothers of schizophrenia patients. 1268 64

Recognition of facially expressed emotions is essential in social interaction. For patients with social phobia, general anxiety disorders, and comorbid anxiety, deficits in their emotion recognition and specific biases have already been reported. This is the first study to investigate facial emotion recognition patterns in patients with panic disorder [PD]. We assumed a general performance deficit in patients with PD. Exploratory analyses should have revealed recognition patterns and specific types of errors. Additionally, we checked the influence of depression and anxiety symptoms, per se, on recognition. A carefully selected group of 37 patients with PD without agoraphobia [DSM-IV 300.01] and no psychiatric comorbidity was compared to 43 controls matched for age and sex. We assessed emotion recognition with the FEEL Test [Facially Expressed Emotion Labeling], using faces displaying fear, anger, sadness, happiness, disgust, and anger. Recognition of emotions in patients with PD was significantly worse than that of controls, specifically, sadness and anger. They also showed a tendency to interpret nonanger emotions as anger. Interestingly, in patients with PD, depressive symptoms were more strongly related to emotion recognition than were anxiety symptoms, and recognition differences between patients and controls disappeared when we controlled for depression. This effect is discussed in the context of previous studies reporting emotion recognition deficits of depressed patients.
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PMID:Emotion recognition patterns in patients with panic disorder. 1697 9

The primary aim of this study was to investigate facial emotion recognition (FER) in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Twenty patients with SFD and 20 healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of FER and the 26-item Toronto Alexithymia Scale. Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistics. This suggests that the deficit in FER observed in the patients with SFD was most likely a consequence of concurrent alexithymia. It should be noted that neither depression nor anxiety was significantly related to emotion recognition accuracy, suggesting that these variables did not contribute the emotion recognition deficit. Impaired FER observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning.
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PMID:Facial emotion recognition and alexithymia in adults with somatoform disorders. 1803 26


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