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Expressed emotion and depression

A longitudinal study

Published online by Cambridge University Press:  03 January 2018

H. Hayhurst*
Affiliation:
Department of Psychiatry, University of Cambridge
Z. Cooper
Affiliation:
Department of Psychiatry, University of Cambridge
E. S. Paykel
Affiliation:
Department of Psychiatry, University of Cambridge
R. Ramana
Affiliation:
Department of Psychiatry, University of Cambridge
S. Vearnals
Affiliation:
Social Psychiatry Section, Institute of Psychiatry, London
*
Dr H. Hayhurst, Box 189, Department of Psychiatry, Addenbrooke's Hospital, Cambridge CB2 2QQ

Abstract

Background

Previous studies show that criticism by relatives during acute depressive illness predicts relapse over nine months, but the course of criticism over time and its relation to the course of illness, have not been examined in depressed patients.

Method

Thirty-nine depressed patients and their partners, were interviewed separately at three-monthly intervals over about one year. Illness was assessed by Research Diagnostic Criteria and Hamilton Depression Rating Scale. Criticism was measured by the Camberwell Family Interview.

Results

Criticism when patients were most depressed predicted neither remission nor subsequent relapse. Patients who fully recovered, with or without later relapse, had partners who were consistently uncritical, or critical only at presentation. Patients with residual symptoms during remission had more persistently critical partners.

Conclusions

The nature of the association between criticism and depression could not be unequivocally established, although it appeared likely that continuing criticism was a result of continuing depression. Relatives' understanding of the illness may mediate between levels of criticism and the course of depression.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

REFERENCES

Andrew, B., Hawton, K., Fagg, J., et al (1993) Do psychosocial factors influence outcome in severely depressed female psychiatric in-patients? British Journal of Psychiatry, 163, 747754.CrossRefGoogle ScholarPubMed
Bladin, K. D., MacCarthy, B., Kuipers, L., et al (1990) Daughters of people with dementia: Expressed emotion, strain and coping. British Journal of Psychiatry, 157, 221227.CrossRefGoogle Scholar
Brewin, C. R., MacCarthy, B., Duda, K., et al (1991) Attribution and expressed emotion in the relatives of patients with schizophrenia. Journal of Abnormal Psychology, 100, 546554.CrossRefGoogle ScholarPubMed
Goering, P. W., Lancee, W. J. & Freeman, S. J. J. (1992) Marital support and recovery from depression. British Journal of Psychiatry, 160, 7682.CrossRefGoogle ScholarPubMed
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.CrossRefGoogle ScholarPubMed
Hooley, J. M. (1985) Expressed emotion: a review of the critical literature. Clinical Psychology Review, 5, 119139.CrossRefGoogle Scholar
Hooley, J. M. & Teasdale, J. D. (1989) Predictors of relapse in unipolar depressives: expressed emotion, marital distress and perceived criticism. Journal of Abnormal Psychology, 98, 229235.CrossRefGoogle ScholarPubMed
Hooley, J. M., Orley, J. & Teasdale, J. D. (1986) Levels of expressed emotion and relapse in depressed patients. British Journal of Psychiatry, 148, 642647.CrossRefGoogle ScholarPubMed
Kuipers, L. (1992) Expressed emotion research in Europe. British Journal of Clinical Psychology, 31, 429443.CrossRefGoogle ScholarPubMed
Leff, J., Kuipers, L., Berkowitz, R., et al (1982) A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121134.CrossRefGoogle ScholarPubMed
Okasha, A. (1995) Reply to Hooley, J. M. and Miklowitz, D. J. Expressed emotion and depression in Egypt (letter). American Journal of Psychiatry, 152, 1240.CrossRefGoogle Scholar
Okasha, A., El Akabawal, A. S., Snyder, K. S., et al (1994) Expressed emotion, perceived criticism and relapse in depression: A replication in an Egyptian community. American Journal of Psychiatry, 151, 10011005.Google Scholar
Paykel, E. S. (1985) The Clinical Interview for Depression: development, reliability and validity. Journal of Affective Disorders, 9, 8596.CrossRefGoogle ScholarPubMed
Paykel, E. S., Ramana, R., Cooper, Z., et al (1995) Residual symptoms after partial remission: an important outcome in depression. Psychological Medicine, 25, 11711180.CrossRefGoogle ScholarPubMed
Paykel, E. S., Cooper, Z., Ramana, R., et al (1996) Life events, social support and marital relationships in the outcome of severe depression. Psychological Medicine, 26, 121133.CrossRefGoogle ScholarPubMed
Ramana, R., Paykel, E. S., Cooper, Z., et al (1995) Remission and relapse in major depression: a two-year prospective follow-up study. Psychological Medicine, 25, 11611170.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.CrossRefGoogle ScholarPubMed
Stirling, J., Tantam, D., Thomas, P., et al (1993) Expressed emotion and schizophrenia: the ontogeny of expressed emotion during an 18-month follow-up. Psychological Medicine, 23, 771778.CrossRefGoogle ScholarPubMed
Vaughn, C. (1977) Patterns of interactions in families of schizophrenics. In Schizophrenia: The Other Side (ed. Katschnig, H.). Vienna: Urban and Schwarzenberg.Google Scholar
Vaughn, C. & Leff, J. (1976a) The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125137.CrossRefGoogle ScholarPubMed
Vaughn, C. & Leff, J. (1976b) The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157165.CrossRefGoogle ScholarPubMed
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