The role of expressed emotions indicator as a predictor of the course of schizophrenia
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Psychiatr Pol 2010;44(2):173–184
Objective. The study is a part of a prospective schizophrenia research project run in Krakow. The general objective of the project is a long-time observation of people with schizophrenia, starting from the first episode through the years of living with the illness, the assessment of treatment results and predictors. The goal of this study was to investigate whether the level of expressed emotions in family at the onset of schizophrenia may have a prognostic value in regard to the further course of the illness. Method. Four indicators of treatment results were observed: the number of relapses, the overall time of inpatient hospitalisations, the number of inpatient hospitalisations and the severity of psychopathological symptoms, all in 3, 7 and 12 years since first hospitalisations. Expressed emotions (EE) were assessed with Camberwell Family Interview (CFI), the severity of symptoms was assessed with BPRS-SA, the UCLA version. Results. 1) The increase of the number of relapses in subsequent follow-ups was more pronounced in the group of subjects with higher EE at the time of their first hospitalisations. 2) The number and overall time of hospitalisations did not correspond in any way with the EE level at the time of the first hospitalisation. 3) The dynamics of general and positive symptoms was related to the EE level at the time of the first hospitalisation. The negative syndrome was found to have no significant relationships. Conclusions. 1) The level of EE at the time of the first hospitalisation can be regarded as a specific predictor of relapses in the study group. 2) Creating research models that enable to differentiate: trait and state as well as dependent on family and on the course of illness aspects of EE, would enable better understanding of this phenomenon, which appears both as predictor and as effect of the course of schizophrenia.