title: Epilepsy and family expressed emotion: results of a prospective study.
abstract: OBJECTIVE
  To verify the emotional components expressed by the relatives of adult patients with a diagnosis of epilepsy, and whether they are related to adjustment to the illness and the course of the illness over time.
  
  
  METHODS
  We studied a consecutive sample of 43 outpatients suffering from epilepsy and 43 key relatives using the Camberwell Family Interview (CFI), with the expressed emotion (EE) of the relatives being rated at baseline (T0). EE refers to a construct representing some key aspects of interpersonal relationships: the relatives were assigned to the high-EE group if they scored 3 or more on the emotional over involvement (EOI) scale, or showed hostility, or made 6 or more critical comments. The patients were clinically evaluated at baseline and for 1 year of appropriate treatment by an epileptologist who was blinded to the EE ratings. They also completed STAI XI, STAI X2 and Beck's Depression Inventory at baseline.
  
  
  RESULTS
  Twenty-six relatives (60%) were rated as showing a high degree of EE. In the 12-month follow-up study, high EE and high EOI were found to be associated with a significantly higher seizure frequency than that recorded for the patients living in low-EE households (p<0.05). The patients from households assessed as reflecting a high degree of criticism showed poor drug compliance (p<0.01), whereas those with relatives assessed as having a high degree of warmth showed better clinical and pharmacological compliance (p<0.01). High family criticism scores also correlated with higher study entry levels of depression (p<0.05) and trait and state anxiety (p<0.05) among the patients.
  
  
  CONCLUSIONS
  The study findings highlight the impact of particular components of the family emotional climate on the clinical course and psychological adjustment of patients with epilepsy.
authors: Psychiatric Clinic, Milan University, Fondazione IRCCS Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy. cinzia.bressi@unimi.it
authors: Cinzia
authors: C
authors: Bressi
authors: Cesare Maria
authors: CM
authors: Cornaggia
authors: Massimiliano
authors: M
authors: Beghi
authors: Matteo
authors: M
authors: Porcellana
authors: Ilaria Ida
authors: II
authors: Iandoli
authors: Giordano
authors: G
authors: Invernizzi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D003710:Demography; D004827:Epilepsy / Q000503:physiopathology / Q000523:psychology*; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010555:Personality Inventory; D011446:Prospective Studies; D018709:Statistics, Nonparametric