Expressed emotion is not associated with disorder severity in first-episode mental disorder.
A family atmosphere characterized by expressed emotion (EE) is a robust predictor of clinical outcome of patients with schizophrenia and mood disorders. However, there is ongoing discussion as to whether EE is more a cause of clinical outcome or a parental reaction to disorder severity. This cross-sectional study examines a sample of 42 consecutive first-episode patients from a defined geographical area with severe mental disorders (schizophrenia-related disorders, psychotic mood disorders, and non-psychotic mood disorders). Their 42 relatives were interviewed, and the relationships between EE variables derived with the five-minute speech sample method (FMSS) and the patients' demographic, premorbid and clinical measures were analyzed. A high EE score was found in 40% of the relatives. High EE was associated with the interviewed relative's not being a spouse and the patient's being young and unmarried. It was not associated with premorbid characteristics, symptom dimensions or the diagnostic group of the patient. These results do not support the hypothesis that EE is a reaction to the clinical features of the patient. Instead, demographic factors may partly mediate the effect of EE on prognosis.
Heikkilä
Jyrki
J
Department of Psychiatry, University of Turku and Turku City Mental Health Center, Kunnallissairaalantie 20, rakennus 9, FIN 20700 Turku, Finland. jyrki.heikkila@turku.fi
Karlsson
Hasse
H
Taiminen
Tero
T
Lauerma
Hannu
H
Ilonen
Tuula
T
Leinonen
Kirsi-Marja
KM
Wallenius
Elina
E
Virtanen
Hilkka
H
Heinimaa
Markus
M
Koponen
Salla
S
Jalo
Päivi
P
Kaljonen
Anne
A
Salakangas
Raimo K R
RK
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology