We performed family psychoeducation for depression, and investigated the association between the education and expressed emotion of patients’ families and relapse of depression.

Of 103 patients diagnosed with major depressive disorder, and their primary family members, 53 patients and their primary family members gave consent. The patients were randomly allocated to an intervention or control group, consisting of 24 and 30 patients, respectively. The intervention group underwent 4 educational sessions and education in coping techniques. The relapse rate was compared between the intervention and control groups. In addition, the subjects were divided into high- and low-EE groups based on the EE judgment, and the effect of psychoeducation was compared in each group.

The relapse rate during a 9-month period was 8.3% in the intervention group, being significantly lower than that (50%) in the control group. The relapse rate in the intervention group was slightly lower than that in the control group in the high-EE group, and significantly lower in the low-EE group. Regarding the influence of EE, in the control group, the relapse rate was 70% in the high-EE group, being significantly higher than that (40%) in the low-EE group. On multiple logistic regression analysis, psychoeducation (odds ratio: 25.53, 95% CI: 2.83-229.92) and the Hamilton score at the time of entry (odds ratio: 1.16, 95% CI: 1.045-1.298) were significantly associated with relapse.

It was suggested that the psychoeducation of families is very effective for the prevention of relapse in adult depressive patients.