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11-10-2011 | Psychology | Article

Familial expressed emotion similar in schizophrenia, high-risk patients


Free abstract

MedWire News: Families of individuals with first-episode schizophrenia and those at high-risk for psychosis express similarly high levels of emotional over-involvement, research shows.

The results of the study "partially support the hypothesis" that a high level of expressed emotion develops as a reaction to the patient's illness, report Angelo Cocchi (Azienda Ospedaliera Ospedale Niguarda Ca' Granda, Milan, Italy) and colleagues in the journal Psychiatry Research.

Expressed emotion describes critical comments, hostility, or emotional over-involvement, such as an exaggerated or overprotective attitude, expressed by relatives when talking about the mentally or physically ill individual.

Studies have shown higher rates of schizophrenic relapse in families with high levels of expressed emotion, but the research is often unable to confirm whether the negativity is the cause or result of the illness.

In this study, Cocchi and colleagues studied 77 families with a member who experienced a first-episode psychosis and 66 families with a member at high risk for schizophrenia.

Approximately one-third of families were classified as expressing high levels of emotion, with emotional over-involvement being the most prominent characteristic.

High expressed emotion correlated with longer durations of untreated illness, while emotional over-involvement correlated with untreated psychosis in first-episode schizophrenia.

In very-high-risk patients, however, high expressed emotion did not correlate with longer durations of untreated illness.

Interestingly, families of individuals at very high risk for psychosis and those with first-episode schizophrenia did not differ in terms of expressed emotion prevalence or any of its subcomponents.

Critical comments of family members were rarely reported in either patient group, a finding "at odds with a high prevalence of criticism, hostility, and rejection consistently reported over the past 40 years in samples of chronically ill patients," report Cocchi and colleagues.

They conclude: "Patients from families with high expressed emotion could possibly benefit from interventions that are targeted at improving their resilience when dealing with problematic family environments."

By MedWire Reporters

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