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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent interest in the way social factors influence the course of schizophrenia has led to attempts to monitor and manipulate these factors. The work on the Expressed Emotion of the relative has been especially influential in this area. A number of studies have now been conducted in which a psychosocial intervention has been employed in an attempt to prevent relapse after discharge from hospital. These studies are reviewed with an emphasis on their methodological adequacy and on the nature of the intervention used. Recent studies have demonstrated a positive result for psychosocial interventions used in combination with neuroleptic medication. However, analysis of these studies does not allow us to conclude that we can identify the 'active ingredients' in these psychosocial treatment regimes. Although there is cause for optimism, further investigation is required.
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PMID:'Psychosocial' interventions with families and their effects on the course of schizophrenia: a review. 614 87

Previous research has demonstrated a different psychophysiological response of schizophrenic patients depending on whether their key relative was rated high or low on Expressed Emotion (EE). A case assessment is described in which a young man suffering from schizophrenia, who lived with both a high EE and a low EE parent, was tested psychophysiologically in their presence using an ABAC design. The patient demonstrated a significantly higher amount of spontaneous activity in skin conductance level when the high EE parent was present. The high EE parent also demonstrated a greater perceived inability to cope, and a higher level of personal distress.
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PMID:Psychophysiological assessment of expressed emotion in schizophrenia. A case example. 646 18

A study is reported of a controlled trial of social intervention in the families of schizophrenic patients at high risk of relapse. The patients were selected for being in high contact with high Expressed Emotion relatives. All patients were maintained on neuroleptic drugs. One half of the 24 families were randomly assigned to routine out-patient care, while the other half received a package of social interventions. This comprised a programme of education about schizophrenia, a group for the relatives, and family sessions for relatives and patients. The relapse rate in the control group was 50 per cent compared with nine per cent in the experimental group (P = 0.04). The stated aims of the therapeutic interventions were achieved in 73 per cent of experimental families. In these families, no patient relapsed. The results provide evidence for the causal role of relatives' expressed emotion (EE) in schizophrenic relapse, as well as for the therapeutic effectiveness of social intervention combined with drug treatment.
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PMID:A controlled trial of social intervention in the families of schizophrenic patients. 711 51

The present study reviews eight series of trials on psycho-social family intervention for schizophrenia based on Expressed Emotion (EE). All studies used randomized controlled trials (RCT) except one which was non-randomized controlled trial. The relapse risk ratios (intervention/control) for 9-12 months after discharge were 0 to .73 and for 24 months were .20 to .57. Taking into account the shortcomings of the studies, the authors conclude that psycho-social family intervention based on EE is effective in preventing schizophrenic relapse, and discuss four important issues: 1) For effective family intervention, methods for Japanese patients should be established from a trans-cultural view point; 2) The interaction of two or more therapeutic measures should be evaluated quantitatively; 3) The mechanisms of schizophrenic relapse prevention through family psycho-social intervention should be explored. A psycho-physiological study including skin conductance measurement is promising; 4) The authors point out the ethical aspect of family intervention, and discuss the importance of informed consent and the need to place emphasis on family's needs.
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PMID:[Family intervention for schizophrenia based on expressed emotion (EE) research: a review of the technique and evaluation]. 764 47

Patients with schizophrenia are sensitive to short term social stressors in the form of life events, and the long term stress of living with high Expressed Emotion (EE) relatives. A number of family interventions have been evaluated in controlled trials. A comparison of successful and unsuccessful interventions indicates the optimal type of intervention for patients in high EE environments.
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PMID:Stress reduction in the social environment of schizophrenic patients. 787 35

The authors present data from an experimental study conducted on 20 institutionalized mentally handicapped adult patients. Relevant family variables were investigated by means of the Expressed Emotion (EE) scales, then compared with similar variables obtained in a matched sample of 20 schizophrenic patients and their families. Results show, in relatives of mentally handicapped patients, a higher rate of Warmth than in relatives of schizophrenics (p = 0.009), while other EE scales appear to reach similar values in both groups. Within the mentally handicapped family group, a higher rate of Emotional Over-involvement (p = 0.046) is shown by relatives of patients treated with neuroleptic drugs. The presence of high Warmth and Emotional Over-involvement, together with low Criticism and Hostility, may be interpreted as adaptation by the families to an organic disease with very early onset, clearer ad less rejecting than schizophrenia.
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PMID:[Mental retardation and family environment: role of emotional factors]. 790 96

We analysed aggregate data from 25 studies linking Expressed Emotion (EE) and schizophrenia. We had access to original data sets from 17 studies, and used published data from the remainder. This provided us with 1346 cases from around the world. The association of EE with relapse was overwhelming, and was maintained whatever the geographical location. The predictive capacity of EE was virtually identical in men and women. While high contact with a high EE relative increased the risk of relapse, the opposite was true in low EE households. Medication and EE were independently related to relapse, and thus EE status has no bearing on the decision to prescribe. Our findings were confirmed using log-linear analysis.
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PMID:The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. 799 53

The predictive validity of the Level of Expressed Emotion (LEE) Scale in a group of schizophrenic patients was examined. Forty-six patients with DSM-III diagnoses of schizophrenic disorders were administered the perceived expressed emotion measure (LEE) and followed up for a 5-year period. Patients' ratings of their social environments were related to rehospitalization 1 year, 2 years (p < .02) and 5 years (p < .01) after initial assessment. These results supported the utility of the LEE in identifying schizophrenic patients at high risk for rehospitalization.
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PMID:Predictive validity of the Level of Expressed Emotion (LEE) Scale: readmission follow-up data for 1, 2, and 5-year periods. 809 49

This article examines the concurrent validity of the Five-Minute Speech Sample (FMSS) as an index of Expressed Emotion in a Dutch sample of 84 parents of adolescents suffering from anorexia or bulimia nervosa. The Camberwell Family Interview (CFI), the criterion measure of EE, and the FMSS were conducted on the same day. The levels of Expressed Emotion in these families were low when compared with the EE ratings from the schizophrenia studies. The FMSS and CFI-EE ratings showed a limited degree of overlap. Whether the limited association between the two methods is due to the low levels of criticism in our sample, to cultural differences and/or to differences in the psychopathology under study remains unclear.
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PMID:The validity of the Five-Minute Speech Sample as an index of Expressed Emotion in parents of eating disorder patients. 824 45

A controlled longitudinal treatment study was carried out to investigate the effect of a behavioral family treatment on Expressed Emotion (EE) and to examine the correspondence between EE changes and relapse rates. Subjects were 52 patients with recent onset schizophrenia or related disorders and their parents. After completion of inpatient treatment they were randomly allocated to individual treatment or individual treatment plus family treatment. The family treatment consisted of education and training in communication and problem-solving skills. Expressed Emotion was measured with the Five-Minute Speech Sample (FMSS). The findings show that family treatment did not have a significant positive effect on EE level. The dichotomous FMSS/EE did not systematically change and these findings were comparable with the results of prior EE research. A scoring system that included all subscores of the FMSS was somewhat more sensitive to changes. In the individual treatment condition relapse rates tended to co-occur with a change in FMSS/EE level, irrespective of the direction of this change.
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PMID:Family treatment, expressed emotion and relapse in recent onset schizophrenia. 935 16


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