title: Expressed emotion in the relatives of people with epileptic or nonepileptic seizures.
abstract: OBJECTIVE
  This study investigated Expressed Emotion (EE) in relatives of people with epileptic or nonepileptic seizures (NES).
  
  
  METHODS
  In a cross-sectional study, we used the Five-Minute Speech Sample to explore EE in the key relative of people with epilepsy (n = 36) and those with NESs (n = 21), as well as levels of anxiety and depression and use of coping strategies.
  
  
  RESULTS
  A significantly greater proportion of relatives of NES than epilepsy patients were rated as high EE. Hostility was evident in more high-EE epilepsy than high-EE NES relatives, whereas emotional overinvolvement and positive relationship ratings tended to be more common in high-EE NES relatives. High- and low-EE epilepsy relatives used problem-focused as opposed to emotion-focused coping strategies significantly more than half the time. High EE and seizure frequency were not associated. Age at onset of the disorder was higher in epilepsy patients with high- than with low-EE relatives.
  
  
  CONCLUSIONS
  Irrespective of etiology, carers for people with seizure disorders may find it hard to adjust to the difficulties these disorders create. Interventions that encourage problem-solving, reappraisals of "loss" and education regarding the causes of some of the patients' behavioral and mood problems seem likely to be beneficial.
authors.affiliation: Institute of Psychiatry, London, England. n.stanhope@iop.kcl.ac.uk
authors.forename: Nicola
authors.initials: N
authors.lastname: Stanhope
authors.forename: Laura H
authors.initials: LH
authors.lastname: Goldstein
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003291:Conversion Disorder / Q000175:diagnosis / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004827:Epilepsy / Q000175:diagnosis / Q000523:psychology*; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D012640:Seizures / Q000175:diagnosis / Q000523:psychology*; D012803:Sick Role