title: Expressed emotion and the course of schizophrenia in Pakistan.
abstract: Aim of the study is to evaluate the predictive power of Expressed Emotion in Schizophrenia relapse in Pakistan.
  
  
  
  A longitudinal study was conducted comprising 53 in-patients' sample diagnosed with Schizophrenia and their 101 key carers. Participants fulfilled DSM-IV-TR criteria for Schizophrenia based on Structural Clinical Interview for the DSM-IV diagnosis. Symptomatic status was measured through Brief Psychiatric Rating Scales-Expanded (BPRS-E). Caregivers' level of EE was assessed through Camberwell Family Interview (CFI). Patients were followed up for 9 months after hospital discharge.
  
  
  
  Relapse rate for patients with high-EE household was 72% as compared with 36% in the low-EE household. Logistic Regression showed a positive relationship between high-EE and relapse (CI 0.06-0.80; p < 0.05). Both hostility and critical comments emerged as significant predictors of relapse. The odds ratio showed that a one unit increase in caregivers' score on the CCs and hostility scales were associated with a 1.29 (CI 1.06-1.56; p < 0.05) and 1.89 (CI 1.14-3.13; p < 0.05) times increased rate of relapse, respectively. Conversely, a non-significant relationship was observed between EOI and relapse.
  
  
  
  The findings from this study confirmed the validity of EE construct in predicting schizophrenia relapse in a Pakistani sample. However, medication compliance has not been experimentally controlled and that is one of the limitations of the study.
authors.affiliation: Department of Psychology, Government College University, Lahore, Pakistan. sarosh_haneef@hotmail.com.
authors.forename: Sarosh
authors.identifier: 0000-0003-4634-6982
authors.initials: S
authors.lastname: Sadiq
authors.affiliation: Surrey Mental Health and Substance Use Services, Station Tower, Surrey, Canada.
authors.forename: Kausar
authors.initials: K
authors.lastname: Suhail
authors.affiliation: Department of Psychology, Australian Catholic University, Fitzroy, VIC, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Gleeson
authors.affiliation: ORYGEN Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Mario
authors.initials: M
authors.lastname: Alvarez-Jimenez
mesh_terms: D000328:Adult; D010054:Brief Psychiatric Rating Scale; D017028:Caregivers / Q000523:psychology; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006791:Hostility; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010154:Pakistan; D012008:Recurrence; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: Expressed emotion; Follow-up; Relapse; Schizophrenia