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IV. Expressed Emotion and Relapse

Published online by Cambridge University Press:  29 January 2018

J. Fiona MacMillan ,
Aviva Gold ,
Timothy J. Crow ,
Anthony L. Johnson  and
Eve C. Johnstone
J. Fiona MacMillan
Affiliation:
Northwick Park Hospital and Clinical Research Centre; Department of Psychiatry, University of Birmingham
Aviva Gold
Affiliation:
Division of Psychiatry, Northwick Park Hospital and Clinical Research Centre
Timothy J. Crow
Affiliation:
Northwick Park Hospital and Clinical Research Centre
Anthony L. Johnson
Affiliation:
MRC Biostatistics Unit MRC Centre, Hills Road, Cambridge CB2 2QH
Eve C. Johnstone*
Affiliation:
Northwick Park Hospital and Clinical Research Centre, Watford Road, Harrow, Middlesex HA1 3UJ
*
∗Correspondence
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Abstract

The relatives of 82 patients in a study of first episodes of schizophrenia were interviewed within six weeks of the index admission; 77 patients were subsequently discharged, and were followed to relapse or readmission. Analysis of relapse-free survival time was used to examine whether the components of ‘expressed emotion’ predicted relapse or response to neuroleptic medication: ‘critical comments' by relatives was the only component present often enough to be used and was inversely related to ‘social contact’. When preadmission duration of illness, and neuroleptic medication following discharge (identified previously as significant predictors of outcome) were taken into account, neither ‘critical comments' nor ‘social contact’ were related to outcome nor to response to medication. The constellation of factors suggested as pathogenic was present only in a minority of cases: many patients lived alone and of those that were with families, most were not in high face-to-face contact with other members. The failure of the components of ‘expressed emotion’ to predict outcome or response to neuroleptic medication suggests that at best, such factors are weak predictors of liability to relapse. Their influence is unlikely to be comparable in magnitude to that of neuroleptic medication.

Type
Papers
Information
The British Journal of Psychiatry , Volume 148 , Issue 2 , February 1986 , pp. 133 - 143
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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