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Links Between Expressed Emotion and Burden of Care in Relatives of Patients with Schizophrenia

Published online by Cambridge University Press:  02 January 2018

Marcia Scazufca  and
Elizabeth Kuipers
Marcia Scazufca*
Affiliation:
Department of Psychology, Institute of Psychiatry
Elizabeth Kuipers
Affiliation:
Department of Psychology, Institute of Psychiatry
*
Marcia Scazufca, Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
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Abstract

Background

Findings that the EE level of a relative may change over time support the idea that EE may represent the circumstances of the relationship between patient and caregiver. The present study examines to what extent EE levels in relatives are related to relatives' burden of care and their perceptions of patients' deficits in social role performance.

Method

Fifty patients recently admitted to hospital with DSM–III–R diagnoses of schizophrenia or schizophreniform disorder were assessed for positive and negative symptoms. Fifty relatives who were living or were in close contact with these patients were interviewed for the assessment of EE and burden of care, and to provide information about patients' social role performance and social and behaviour problems.

Results

High-EE relatives had considerably higher mean scores for burden of care than low-EE relatives (12.5 v. 6.8, respectively, P=0.002), and perceived more deficits in patients' social functioning than low-EE relatives (means: 16.2 v. 6.9, respectively, P=0.004). The employment status of relatives was the only socio-demographic characteristic of relatives and patients associated with EE levels, those who were working being less likely to be high EE. Patients' psychopathology was not associated with EE levels and burden of care.

Conclusions

This study shows that EE and the burden of care are related. EE and burden both measure aspects of the relationship between relatives and patients. These findings suggest that EE and burden of care are more dependent on relatives' appraisal of the patient condition than on patients' actual deficits.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 5 , May 1996 , pp. 580 - 587
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Barrowclough, C. & Tarrier, N. (1990) Social functioning in schizophrenic patients. The effects of expressed emotion and family intervention. Social Psychiatry and Psychiatric Epidemiology, 25, 125–129.Google Scholar
Bebbington, P. & Kuipers, L. (1994) The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychological Medicine, 24, 707–718.Google Scholar
Brewin, C. R., Wing, J. K., Mangen, S. P., et al (1987) Principles and practice of measuring needs in the long-term mentally ill: the MRC Needs for Care Assessment. Psychological Medicine, 17, 971–981.CrossRefGoogle ScholarPubMed
Brewin, C. R., Veltro, F., Wing, J. K., et al (1990) The assessment of psychiatric disability in the community. A comparison of clinical, staff, and family interviews. British Journal of Psychiatry, 157, 671–674.CrossRefGoogle ScholarPubMed
Brown, G. W. (1959) Experiences of discharged chronic schizophrenic patients in various types of living groups. The Millbank Memorial Fund Quarterly, 37, 105–131.Google Scholar
Brown, G. Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–258.Google Scholar
Dunn, G. (1994) Statistical methods for measuring outcomes. Social Psychiatry and Psychiatric Epidemiology, 29, 198–204.CrossRefGoogle ScholarPubMed
Fadden, G., Bebbington, P. & Kuipers, L. (1987) The burden of care: the impact of functional psychiatric illness on the patient's family. British Journal of Psychiatry, 150, 287–292.Google Scholar
Gibbons, J. S., Horn, S. H., Powell, J. M., et al (1984) Schizophrenic patients and their families: a survey in a psychiatric service based on a DGH unit. British Journal of Psychiatry, 144, 70–77.Google Scholar
Glynn, S. M., Randolph, E. T., Eth, S., et al (1990) Patient psychopathology and expressed emotion in schizophrenia. British Journal of Psychiatry, 157, 877–880.CrossRefGoogle ScholarPubMed
Hogarty, G. E., Anderson, C. M., Reiss, D. J., et al (1986) Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One-year effects of a controlled study on relapse and expressed emotion. Archives of General Psychiatry, 43, 633–642.CrossRefGoogle Scholar
Hosmer, D. & Lemeshow, S. (1989) Applied Logistic Regression. New York: Wiley.Google Scholar
Jackson, H. J., Smith, N. & McGorry, P. (1990) Relationship between expressed emotion and family burden in psychotic disorders: an exploratory study. Acta Psychiatrica Scandinavica, 82, 243–249.CrossRefGoogle ScholarPubMed
Kay, S. R., Opler, L. A. & Lindenmayer, J. P. (1989) The Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. British Journal of Psychiatry, 155, 59–65.Google Scholar
Kuipers, L. & Bebbington, P. (1988) Expressed emotion research in schizophrenia: theoretical and clinical implications. Psychological Medicine, 18, 893–909.CrossRefGoogle ScholarPubMed
Kuipers, L. (1993) Family burden in schizophrenia: implications for services. Social Psychiatry and Psychiatric Epidemiology, 28, 207–210.CrossRefGoogle ScholarPubMed
Lawton, M. P., Kleban, M. H., Moss, M., et al (1989) Measuring caregiving appraisal. Journal of Gerontology, 44, 61–71.CrossRefGoogle ScholarPubMed
Leff, J. P. & Vaughn, C. E. (1985) Expressed Emotion in Families. New York: Guilford Press.Google Scholar
Maccarthy, B., Lesage, A., Brewin, C. R., et al (1989) Needs for care among the relatives of long-term users of day care. Psychological Medicine, 19, 725–736.Google Scholar
Otsuka, T., Nakane, Y. & Ohta, Y. (1994) Symptoms and social adjustment of schizophrenic patients as evaluated by family members. Acta Psychiatrica Scandinavica, 89, 111–116.CrossRefGoogle ScholarPubMed
Platt, S., Weyman, A., Hirsch, S., et al (1980) The Social Behaviour Assessment Schedule (SBAS): rationale, contents, scoring and reliability of a new interview schedule. Social Psychiatry, 15, 43–55.CrossRefGoogle Scholar
Smith, J., Birchwood, M., Cochrane, R., et al (1993) The needs of high and low expressed emotion families: a normative approach. Social Psychiatry and Psychiatric Epidemiology, 28, 11–16.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C. E., et al (1988) The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532–542.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976) The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Program. London: Cambridge University Press.Google Scholar
Wykes, T. & Sturt, E. (1986) The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry, 148, 1–11.CrossRefGoogle ScholarPubMed
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