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Influence of carer expressed emotion and affect on relapse in non-affective psychosis

Published online by Cambridge University Press:  02 January 2018

E. Kuipers ,
P. Bebbington ,
G. Dunn ,
D. Fowler ,
D. Freeman ,
P. Watson ,
A. Hardy  and
P. Garety
E. Kuipers*
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, London
P. Bebbington
Affiliation:
Department of Mental Health Sciences, Royal Free and University College London Medical School, London
G. Dunn
Affiliation:
Biostatistics Group, Division of Epidemiology and Health Sciences, University of Manchester, Manchester
D. Fowler
Affiliation:
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich
D. Freeman
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, London, UK
P. Watson
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, London, UK
A. Hardy
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, London, UK
P. Garety
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, London, UK
*
Professor E. Kuipers, Department of Psychology PO Box 77, Institute of Psychiatry, King's College London, London SE5 8AF, UK. E-mail: [email protected]
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Abstract

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Background

High expressed emotion in carers predicts relapse in psychosis, but it is not known why this is so. In our cognitive model of psychosis, we postulated that the effect is mediated through affective changes.

Aims

To investigate the relationships between carer expressed emotion, patients' symptoms and carer characteristics during a recent relapse of psychosis.

Method

A total of 86 patients and carers were investigated in a cross-sectional design.

Results

Patients whose carers showed high expressed emotion had significantly higher levels of anxiety and depression, but not more psychotic symptoms or lower self-esteem. Linear regression showed that carers' critical comments predicted anxiety in patients. Critical comments were related to low carer self-esteem and avoidant coping strategies. Low carer self-esteem was also related to carer depression, stress and carer ‘burden’, and to low patient self-esteem.

Conclusions

Our hypothesis was partially supported. Carer criticism was associated with patient anxiety, low carer self-esteem and poor carer coping strategies. Family interventions should focus on improving these after a relapse of symptoms of psychosis.

Type
Papers
Information
The British Journal of Psychiatry , Volume 188 , Issue 2 , February 2006 , pp. 173 - 179
Copyright
Copyright © 2006 The Royal College of Psychiatrists 

Footnotes

Declaration of Interest

None. Funding detailed in Acknowledgements.

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