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Schizophrenia Bulletin 1999 25(2):377-386;
© 1999 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

Expressed Emotion and Relapse in Young Schizophrenia Outpatients

Suzanne King, Ph.D. and Mike J. Dixon
Associate Professor, Department of Psychiatry, McGill University Montreal, Québec, Canada
Assistant Professor, Department of Psychology, University of Waterloo Waterloo, Ontario, Canada

Send reprint requests to Dr. S. King, Douglas Hospital Research Centre, 6875 Lasalle Boulevard, Verdun, Québec, H4H 1R3, Canada

High familial expressed emotion (EE) reliably predicts 9-month relapse rates in schizophrenia patients. Difficulties interpreting the EE-relapse finding arise, however, because EE is usually assessed during a hospital admission, yet relapse following discharge is predicted. Researchers in Scotland assessed EE in relatives while the patients were out of hospital; using conservative relapse criteria, they failed to find higher subsequent 6- and 12-month relapse rates among patients living in high-EE homes (McCreadie and Phillips 1988). Our goal was to determine the ability of EE to predict relapse in a sample of 69 schizophrenia outpatients using both conservative criteria (for 6- and 12-month rates) and standard relapse criteria (for 9- and 18-month rates). According to the conservative criteria, EE failed to predict 6- and 12-month relapse. According to the standard criteria, 9-month relapse rates were significantly greater among patients in high-EE households. In parental homes, relapse at both 9 months and 18 months was best predicted by fathers' critical comments and mothers' emotional overinvolvement. Relapse was not associated with medication compliance and the amount of contact with high-EE relatives.

Keywords: Expressed emotion / relapse / mothers and fathers


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