Objective: Although the effects of caregivers expressed emotion on the relapse of patients with schizophrenia have been studied widely, there is a relative paucity of research on how the patients perceived expressed emotion affects outcome in schizophrenia. The main aim of this study was to examine the relative impacts of patients perceived expressed emotion and the caregivers expressed emotion on the symptom severity of patients with schizophrenia.
Method: In this prospective study, at the first assessment session, 116 stable patients were administered the Perceived Expressed Emotion Scale (PEES), the Positive and Negative Symptom Scale for Schizophrenia (PANSS) as the primary outcome measure. Their caregivers were administered the Expressed Emotion Scale (EES). At the second assessment six months later, PANNS was re-administered to the patients.
Results: The patients perceived expressed emotion was more important than caregivers expressed emotion on symptom severity. It was found that patients perceived criticism/hostility (C/H) was a risky element on positive and negative symptoms, and on the total scores of PANSS. Patients perceptions of emotional over-involvement (EOI) appeared to be stronger protectors against relapse than C/H.
Conclusion: Family environments with high EOI may protect against relapse in patients with schizophrenia. This finding can be interpreted in cross-cultural context. Psychosocial interventions should foster and maintain according to the cultural differences. The limitations and clinical implications of the results and directions for future studies were suggested.
Key words: Expressed emotion, perceived expressed emotion, positive and negative symptoms, schizophrenia
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