Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T08:35:16.723Z Has data issue: false hasContentIssue false

Treatment, expressed emotion and relapse in recent onset schizophrenic disorders

Published online by Cambridge University Press:  09 July 2009

D. Linszen*
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
P. Dingemans
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
J. W. Van Der Does
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
A. Nugter
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
P. Scholte
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
R. Lenior
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
C. Vanier
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
M. J. Goldstein
Affiliation:
Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam and Department of Psychiatry, Leiden University, Leiden, The Netherlands; and Department of Psychology, University of California, Los Angeles, USA
*
1Address for correspondence: Dr Don H. Linszen, Academic Medical Centre. University of Amsterdam, Department of Psychiatry. Tafelbergweg 25, 1105 BC, Amsterdam, The Netherlands.

Synopsis

The effect of in-patient and individual orientated psychosocial intervention (IPI) and in-patient and individual and family orientated intervention (IPFI) across levels of expressed emotion (EE) on relapse was compared in a group of patients with recent onset schizophrenic disorders. Patients were randomly assigned to an individual orientated psychosocial intervention programme or to an identical psychosocial programme plus a behavioural family intervention. Seventy-six patients were studied during a 12 month out-patient treatment period after an in-patient treatment programme in which parents followed a psychoeducational programme. Overall relapse rates during the out-patient interventions were low (16%). Adding family intervention to the psychosocial intervention did not affect the relapse rate. Patients in low EE families relapsed slightly more often during the psychosocial plus family intervention. In-patient treatment with psychoeducation for parents, followed by an out-patient psychosocial intervention programme, has a favourable impact on relapse. Additional family intervention may increase stress in low EE families, thus affecting relapse in their children.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). APA: Washington, DC.Google Scholar
Anderson, C. M., Reiss, D. J. & Hogarty, G. E. (1986). Schizophrenia and the Family. Guilford Press: New York.Google Scholar
Breier, A., Schreiber, J. L., Dyer, J. & Pickar, D. (1991). National Institute of Mental Health Longitudinal Study of Chronic Schizophrenia: prognosis and predictors of outcome. Archives of General Psychiatry 48, 239246.CrossRefGoogle ScholarPubMed
Cozolino, L., Goldstein, M. J., Nuechterlein, K. H., West, K. L. & Snyder, K. S. (1988). The impact of education about schizophrenia on relatives varying in expressed emotion. Schizophrenia Bulletin 14, 675687.CrossRefGoogle ScholarPubMed
Dixon, W. J., Brown, M. B., Engelman, L. & Jennrich, R. I. (eds) (1990). BMDP Statistical Software Manual, vols I and II. University of California Press: Berkeley.Google Scholar
Falloon, I. R. H., Boyd, J., McGill, C. W., Razani, J., Moss, H. B. & Gilderman, A. M. (1982). Family management in the prevention of exacerbations of schizophrenia – a controlled study. New England Journal of Medicine 306, 14371440.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L. & McGill, C. W. (1984). Family Care of Schizophrenia. Guilford Press: New York.Google Scholar
Glick, I. D., Spencer, J. H.Clarkin, J. F. Jr, Haas, G. L., Lewis, A. B., Peyser, J., De Mane, N., Good-Ellis, M., Harris, E. & Lestelle, V. (1990). A randomized clinical trial of in-patient family intervention. IV. Followup results for subjects with schizophrenia. Schizophrenia Research 3, 187200.CrossRefGoogle Scholar
Goldstein, M. J., Rodnick, E. H., Evans, J. R., May, P. R. A. & Steinberg, M. R. (1978). Drug and family therapy in the aftercare of acute schizophrenics. Archives of General Psychiatry 35, 11691177.CrossRefGoogle ScholarPubMed
Hays, W. L. (1980). Statistics for the Social Sciences, 2nd edn.Holt, Reinhardt & Wilson Inc: London.Google Scholar
Hogarty, G. E., Anderson, C. M., Reiss, D. J., Kornblith, S. J., Greenwald, D. P., Javna, D. & Madonia, M. J. (1986). Family psychoeducation, social skills-training, and chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry 43, 633642.CrossRefGoogle ScholarPubMed
Hollingshead, A. B. & Redlich, F. C. (1968). Social Class and Mental Illness pp. 387397. John Wiley: New York.Google Scholar
Kavanagh, D. J. (1992). Recent developments in expressed emotion and schizophrenia. British Journal of Psychiatry, 160, 601620.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R., Eberlein-Vries, E. & Sturgeon, D. (1982). A controlled trial of social intervention in families of schizophrenic patients. British Journal of Psychiatry 141, 121134.CrossRefGoogle ScholarPubMed
Linszen, D. H., Dingemans, P. M., Lenior, M. A., Nugter, M. A., Scholte, W. F. & Van der Does, A. J. W. (1994). Different relapse criteria in schizophrenia disorders. Psychiatry Research 54, 273281.CrossRefGoogle Scholar
Lukoff, D., Nuechterlein, K. H. & Ventura, J. (1986). Manual for the expanded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin 12, 594602.Google Scholar
Norušis, M. J. (1990). SPSSPC+ 4.0 Base Manual for the IBM PC /-XT/AT and PS/2. SPSS Inc.: Chicago.Google Scholar
Nuechterlein, K. H., Snyder, K. S., Dawson, M. E., Rappe, S., Gitlin, M. & Fogelson, D. (1986). Expressed emotion, fixed dose fluphenazine decanoate maintenance and relapse in recent-onset schizophrenia. Psychopharmacology Bulletin 22, 633639.Google ScholarPubMed
Randolph, E. T., Spencer, E. T. H., Glynn, S. M., Paz, G. G., Leong, G. B., Shaner, A. L., Strachan, A., Van Vort, W., Escobar, J. I. (1994). Behavioural family management in schizophrenia: outcome of a clinic-based intervention. British Journal of Psychiatry 164, 501506.CrossRefGoogle ScholarPubMed
Strauss, J. S. & Carpenter, W. T. Jr (1974). The prediction of outcome in schizophrenia. II. Relationships between predictor and outcome variables. Archives of General Psychiatry 31, 3742.CrossRefGoogle ScholarPubMed
Strauss, J. S. & Carpenter, W. T. Jr (1977). Prediction of outcome in schizophrenia. III. Five year outcome and its predictors. Archives of General Psychiatry 34, 159163.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C., Bamrah, J. S., Porceddu, K., Watts, S. & Freeman, H. (1988). The community management of schizophrenia – a controlled trial of a behavioural intervention with families to reduce relapse. British Journal of Psychiatry 153, 532542.CrossRefGoogle ScholarPubMed
Vaughn, C. E. & Leff, J. P. (1976). The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social Psychology 15, 157165.Google ScholarPubMed