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

Despite the strong evidence in the literature for considering Expressed Emotion (EE) as a relapse predicting factor in schizophrenia, there are still several aspects open to discussion. One of the controversial issues is whether EE is only an intrinsic characteristic of the family or, at least partially, a response to schizophrenic symptoms. The aim of this study is to analyse the relationship between EE, and each one of its single components, and the patients clinical characteristics. It is an observational study including a sample of 120 schizophrenic patients and their families. Patients have been evaluated for their clinical status as well as their social adjustment, and the key relatives have been assessed with the Camberwell Family Interview. We have found a statistically significant association between the severity of psycotic symptoms and critical comments, as well as with hostility. However, no association was found between clinical severity and the global status of EE. Results are compared with other studies and possible explanations for those discussed.
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PMID:[Emotional family environment and clinical profile in schizophrenia]. 938 59

The influence of environmental factors upon the social skills in schizophrenia is beyond doubt. The family environment of schizophrenic patients has been extensively described. Some research revealed those features of emotional context of the family, which influence the exacerbation of schizophrenia. Those features are called the Expressed Emotion Index (EE). The Expressed Emotion Index has great prognostic value and it seems interesting to examine the influence of the family environment as described by EE, upon the social skills. This paper contains both a characterization of the family environment described by various aspects of EE and an analysis of its influence on the social skills. Possible connections of EE with premorbid functioning of schizophrenic patients, and with psychopathological symptoms, as well as cognitive processes are also described. In the analysis of interrelation of EE and the social skills it is very important to consider both qualitative and quantitative aspects of Expressed Emotion Index. Various aspects of the family environment seem to be connected with specific cognitive dysfunctions and various psychopathological symptoms. In a similar way, various social skills seem to be determined by different internal and external factors.
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PMID:[The features of family environment and social skills in schizophrenia]. 952 74

This study investigated whether the Expressed Emotion (EE) status of families is associated with an increased risk of negative and depressive symptoms in schizophrenia. The subjects were 52 schizophrenic patients from mental hospitals in Kochi, Japan, who satisfied the DSM-III-R or ICD-9 criteria for schizophrenia. The Japanese version of the Camberwell Family Interview was administered to 73 key relatives of the patients within 2 weeks after admission. A certified rater evaluated the EE's status of each family, using an audiotaped interview and its transcript. Using cohort study design, the subjects were followed for 9 months after their discharge and were monitored for negative and depressive symptoms. Trained psychiatrists who were blind to the EE status of the patients' households administered the Brief Psychiatric Rating scale (BPRS) at discharge, and 9 months after discharge. Repeated-measures analyses of variance showed that EE effects were significant in Emotional withdrawal in all subjects, Depressive mood and Total depressive symptoms in non-relapsers. A multiple regression analyses revealed that EE's effect was significant only in Depressive mood in non-relapsers controlling confounding factors. In non-relapsers in positive symptoms, high EE families could make patients depressed. EE's effect on negative symptoms remains to be established.
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PMID:Expressed emotion of families and negative/depressive symptoms in schizophrenia: a cohort study in Japan. 985 Sep 82

Expressed Emotion (EE) has been shown to be predictive of course or severity in many illnesses, but the studies have been largely of white middle-class patients. This study examined gender and racial differences in parental EE level and communication patterns between the parent and patient with schizophrenia, using data from the NIMH Treatment Strategies in Schizophrenia study. Dialogues (n = 140) from 54 patient-parent dyads were coded into the Relational Control Coding System. Resultant data (n = 13,605 sequences) were analyzed with log-linear models. Results show that the relationship between control and EE level was stronger in African American families compared to Caucasians. Gender differences were as expected, with daughters less competitive and more deferential to their parents. Although the total number of high-EE parents with daughters was small, patterns in these families showed parents who responded submissively in contrast to the competitive symmetry in families with male patients.
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PMID:Racial and gender differences in expressed emotion and interpersonal control in families of persons with schizophrenia. 1066 24

Much research has been carried out on the impact of family relationships on the development and course of different illness. Research on Expressed Emotion (EE) developed out of studies of the impact of family members on patients with schizophrenia, and has provided us with a robust measure of relatives' emotional attitudes towards patients, which has now been applied in the study of numerous psychiatric and medical illnesses. This review outlines the history of EE research in schizophrenia, and discusses the evidence for the association between family EE and the course of schizophrenic illness. Some of the factors which might moderate the association between EE and illness course are outlined and the issues of the meaning and development of EE are discussed in the light of recent theoretical advances. The application of the EE methodology in other psychiatric and medical conditions is then reviewed and conclusions are drawn about the extent to which EE predicts illness course in conditions other than schizophrenia. Consideration is given to the ways in which the application of the paradigm to a variety of illnesses or conditions with different features can enhance our understanding of the EE construct.
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PMID:A review of expressed emotion research in health care. 1086 Jan 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

The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.
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PMID:Acceptance and expressed emotion in Mexican American caregivers of relatives with schizophrenia. 1860 22

Expressed emotion of families of people with schizophrenia is useful and important to evaluate the effects of family interventions. This study tested the reliability and validity of a Chinese version of the Level of Expressed Emotion scale. This psychometric analysis included tests of content validity and reliability, and an exploratory factor analysis. Results indicated that the Chinese version had a high level of equivalence with the original English version and demonstrated good internal consistency and test-retest reliability. The refined 52-item Chinese version consisted of four factors, indicating satisfactory correlation with two theoretically relevant scales. The Chinese version appears psychometrically sound as a measure of schizophrenic patients' perceptions of their family members' expressed emotion.
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PMID:Testing the psychometric properties of a Chinese version of the Level of Expressed Emotion scale. 1880 Mar 79

This study examined whether Perceived Criticism (PC) was related to community functioning in a sample of African-American consumers with schizophrenia. The study tested assumptions from the Expressed Emotion literature that were based primarily on samples of white consumers. The study found that PC affected psychiatric symptomatology but not psychosocial functioning. Greater family contact was strongly related to better psychosocial functioning. Findings suggested that the nature and impact of contact between consumer and family for this sample of African-Americans appears different from what has been found in white, middle-class samples.
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PMID:The relationships among perceived criticism, family contact, and consumer clinical and psychosocial functioning for African-American consumers with schizophrenia. 1884 74

In the field of early psychosis psychoeducation is considered fundamental to increase coping skills with diseases and to improve the quality of life of patients and their families. The more recent and updated guidelines on schizophrenia underline the extreme importance of the families involvement in treatment of young people in the initial phases of illness. "Families are the main support for many young patients. They could be the primary carers but they have also to face individual and social consequences following the onset course. Where feasible, family members must be involved in the treatment". This work describes the components of the work with families carried on by the Centre for the early detection of psychoses and high-risk situations--Programma 2000 ("Niguarda Ca' Granda" Hospital-Milan) and is mostly focused on psychoeducation and on Expressed Emotions aspects. Even the advances suggested by the international literature drove Programma 2000 to define both the steps of caregivers assessment and intervention. During the last ten years, Programma 2000 has followed 191 caregivers. Aims of this work is to verifier the outcome of the "pilot project", started in 2007, projected specifically to increase the normally used strategies to improve the caregivers adherence and involvement in the therapeutic process. The individualized multi-componential intervention has been structured in 8 session over one years. Outcome measures used in this article are the scores of the Camberwell Family Interview and from the Psychosis Knowledge Assessement Semistructured Interview (VCP). The subjects enrolled in the structured pilot project were 25 family caregiver to young (18-30 yrs old) patients. Results shows change in the Expressed Emotion level: 13% of families moved from High Expressed Emotion to Low Expressed Emotion. Furthermore data on the knowledge of illness knowledge level illustrate a reduction in the percentage, from 47% to 18%, of carers who have just a very vague knowledge of illness, and an increase from 16% to 27% of carers who obtain a good level of specific knowledge. In conclusion we can sustain mental health expert with aim to treatment project programme individualized and multi-componential tailored for young's caregiver at the onset phase of psychosis.
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PMID:[Working with families in the early stages of psychosis: a structured intervention for caregivers]. 1928 79


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