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Expressed Emotion and Schizophrenia in North India

III. Influence of Relatives' Expressed Emotion on the Course of Schizophrenia in Chandigarh

Published online by Cambridge University Press:  02 January 2018

J. Leff*
Affiliation:
MRC Social Psychiatry Unit
N. N. Wig
Affiliation:
Regional Adviser for Mental Health, WHO Eastern Mediterranean Regional Office, Alexandria, Egypt
D. K. Menon
Affiliation:
Indian Council of Medical Research, Ansari Nagar, New Delhi
H. Bedi
Affiliation:
Institute of Medical Education and Research, Chandigarh, India, (formerly Social Scientist, Department of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health, Chandigarh)
L. Kuipers
Affiliation:
The Maudsley Hospital, London
A. Ghosh
Affiliation:
St David's Hospital, Carmarthen, Wales
H. Bedi
Affiliation:
Institute of Medical Education and Research, Chandigarh, India, (formerly Social Scientist, Department of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health, Chandigarh)
D. K. Menon
Affiliation:
Indian Council of Medical Research, Ansari Nagar, New Delhi
L. Kuipers
Affiliation:
The Maudsley Hospital, London
A. Korten
Affiliation:
Social Psychiatry Research Unit, Australia National University, Canberra
G. Ernberg
Affiliation:
Division of Mental Health, WHO, Geneva
R. Day
Affiliation:
Psychiatric Epidemiology Programme, University of Pittsburgh, Pennsylvania
N. Sartorius
Affiliation:
Division of Mental Health, WHO, Geneva
A. Jablensky
Affiliation:
Division of Menial Health, WHO, Geneva
*
MRC Social Psychiatry Unit, Friern Hospital, Friern Barnet Road, London NII

Extract

We conducted a one-year follow-up of patients who had made a first contact with psychiatric services in Chandigarh, North India, and had been assigned a diagnosis of schizophrenia. The expressed emotion (EE) of the patients' relatives was assessed early on. We found the same associations between the individual components of EE and relapse of schizophrenia as in previous Anglo-American studies, but only the association between hostility and relapse was statistically significant. Applying the same criteria as in the Anglo American studies for ‘high EE’, we found a significant relationship between high EE and relapse. This relationship was not explained by other factors often associated with higher relapse rates. We conclude that the significantly better outcome of Chandigarh first-contact patients compared with a London sample is largely due to the significantly lower proportion of high-EE relatives in the North Indian sample.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1987 

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References

Brown, G. W. & Birley, J. L. T. (1968) Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behaviour, 9, 203214.CrossRefGoogle ScholarPubMed
Brown, G. W. & Birley, J. L. T. & Rutter, M. (1966) The measurement of family activities and relationships: methodological study. Human Relations, 19, 241263.CrossRefGoogle Scholar
Brown, G. W., 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, 241258.CrossRefGoogle ScholarPubMed
Day, R., Nielsen, A., Korten, A., Ernberg, G., Dube, K. C., Gebhart, J., Jablensky, A., Leon, C., Marsella, A., Olatawura, M., Sartorius, N., Stromgren, E., Takahashi, R., Wig, N. & Wynne, L. C. (in press) Stressful life events preceding the acute onset of schizophrenia: A cross-national study from the World Health Organization. Culture, Medicine and Psychiatry.Google Scholar
Hooley, J., Orley, J. & Teasdale, J. T. (1986) Levels of expressed emotion and relapse in depressed patients. British Journal of Psychiatry, 148, 632641.CrossRefGoogle ScholarPubMed
Kuipers, L. (1979) Expressed emotion: a review. British Journal of Social and Clinical Psychology, 18, 237243.CrossRefGoogle ScholarPubMed
Leff, J. P. (1981) Psychiatry Around the Globe: A Transcultural View. New York: Dekker.Google Scholar
Leff, J. P. & Vaughn, C. (1980) The interaction of life events and relatives' expressed emotion in schizophrenia and depressive neurosis. British Journal of Psychiatry, 136, 146153.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R., Eberlein-Fries, R. & Sturgeon, D. (1982) A controlled trial of intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121134.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R., Vaughn, C. & Sturgeon, D. (1983) Life events, relatives' expressed emotion and maintenance neuroleptics in schizophrenic relapse. Psychological Medicine, 13, 799807.Google Scholar
Miklowitz, D. S., Goldstein, M. S., Falloon, I. R. H. & Doane, J. A. (1984) Interactional correlates of expressed emotion in the families of schizophrenics. British Journal of Psychiatry, 144, 482487.CrossRefGoogle ScholarPubMed
Radhakrishnan, J., Kuruvilla, M., Richard, J. & Verghese, A. (1983) Schneider's first rank symptoms: prevalence, diagnostic use and prognostic implications. British Journal of Psychiatry, 142, 557559.CrossRefGoogle ScholarPubMed
Rutter, M. & Brown, G. W. (1966) The reliability and validity of measures of family life and relationships in families containing a psychotic patient. Social Psychiatry, 1, 3853.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976a) The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125137.CrossRefGoogle ScholarPubMed
Vaughn, C. E. & Leff, J. P. (1976b) The measurement of expressed emotion in families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157165.CrossRefGoogle ScholarPubMed
Vaughn, C. E., Snyder, K. S., Jones, S., Freeman, W. B. & Falloon, I. R. H. (1984) Family factors in schizophrenic relapse: a California replication of the British research on expressed emotion. Archives of General Psychiatry, 14, 11691177.Google Scholar
Waxler, N. E. (1979) Is outcome for schizophrenia better in nonindustrial societies? The case of Sri Lanka. Journal of Nervous and Mental Diseases, 167, 144158.Google Scholar
Wig, N. N., Menon, D. K., Bedi, H., Ghosh, A., Kuipers, L., Leff, J., Korten, A., Day, R., Sartorius, N., Ernberg, G. & Jablensky, A. (1986a) The cross-cultural transfer of ratings of relatives' expressed emotion. British Journal of Psychiatry, 151, 156160.CrossRefGoogle Scholar
Wig, N. N., Menon, D. K., Bedi, H., Leff, J., Kuipers, L., Ghosh, A., Day, R., Korten, A., Ernberg, G., Sartorius, N. & Jablensky, A. (1986b) Distribution of expressed emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh. British Journal of Psychiatry, 151, 160165.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
World Health Organisation (1979) Schizophrenia: An International Follow-up Study, Vol. II. Chichester, New York: John Wiley.Google Scholar
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