title: Expressed emotion among relatives of chronic pain patients, the interaction between relatives' behaviours and patients' pain experience.
abstract: BACKGROUND
  Chronic pain is a sensory and emotional experience that causes significant disturbances to a patient's life as well as to their family. Whether the family environment is affected by chronic pain and, in turn, affects the patients' pain experience has yet to be investigated. The interaction between patients and spouses has been assessed using the expressed emotion (EE) construct, a tool previously described in the field of mental health. For schizophrenia and other psychiatric illnesses, a correlation exists between family EE and patients' outcomes.
  
  
  OBJECTIVE
  The main objective of this study was to observe the presence of EE among relatives of chronic spinal pain patients and to evaluate its correlation with their symptoms.
  
  
  METHODS
  A prospective observational study was conducted on 54 patients and their spouses currently seen at the Chronic Pain Unit of Hospital Clinic of Barcelona. The following variables were recorded: age, gender, pain score, quality of life and EE.
  
  
  RESULTS
  Data showed that a considerable proportion of spouses were rated as high EE. There was an association between EE and patients' quality of life, and the level of EE predicted some other variables of patients' quality of life.
  
  
  CONCLUSIONS
  The EE level of spouses of chronic pain patients affects the patients' quality of life and thus the way that they experience their pain.
authors.affiliation: 1Clinical Psychologist, Family Therapist, Chronic Pain Clinic, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Ballús-Creus
authors.forename: M Virginia
authors.initials: MV
authors.lastname: Rangel
authors.forename: Alba
authors.initials: A
authors.lastname: Peñarroya
authors.forename: Jordi
authors.initials: J
authors.lastname: Pérez
authors.forename: Julian
authors.initials: J
authors.lastname: Leff
mesh_terms: D001294:Attitude to Health; D059350:Chronic Pain / Q000523:psychology*; D019260:Expressed Emotion / Q000502:physiology*; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D013030:Spain; D018454:Spouses / Q000523:psychology*
keywords: Expressed emotion; chronic pain; family environment; pain intensity; quality of life; spouses