Expressed Emotion as a Precipitant of Relapse in Schizophrenia and Bipolar Disorder

Context A number of research has demonstrated that Expressed Emotion (EE) predicts clinical relapse in a number of psychiatric disorders. Influence of EE has been found to be one of the robust predictors of relapse in Schizophrenia and Bipolar Disorder. Aims The present study was to assess the relationship between Expressed Emotion (EE) and relapse cases of Schizophrenia and Bipolar disorder and socio-demographic characteristics of patients and their caregivers. Materials and Methods In one year period from 1st September 2010 to 31st August 2011 consecutive relapse cases of Schizophrenia and Bipolar disorder admitted in the Psychiatric Ward of RIMS Hospital and corresponding caregivers/influential others was taken up for study and information regarding socio-demographic characteristics (e. g. age, gender, domicile) was recorded on a semi-structured proforma. Results A total of 64 cases and corresponding 64 caregivers/influential others were taken up and analysed. Out of these 32 cases were Schizophrenics, 30 were BPAD in Mania and remaining 2 belonged to BPAD in depression. The mean age of the patients was 30.23 years with SD7.53. Maximum of the patients (26.6 %) fell in the 19 -24 years age group. Majority (56.25 %) of the inpatients were females and the remaining (43.75 %) were males. Most of the patients were from rural areas, unemployed and most were educated up to class-XII and most of them belonged to the monthly income group of Rs 5000-10000. Majority of the caregivers/ influential others were parents with mean age being 43.61 yrs. Most of the caregivers were females (64.1 %) and from nuclear families (54.7 %) most of them are illiterate (32.8 %). In both cases of Schizophrenia and BPAD Mania there was highly significant correlation between the scores of (Family Interaction Pattern Scale) FIPS with the duration of illness and also a high positive correlation between duration of untreated illness and number of relapse. Conclusion Research on the influence of the family environment on the onset and course of mental illness including relapse is critical to the understanding of the mechanism for relapse and for the development of appropriate psychosocial interventions. It is now clear that negative family atmosphere plays a role in relapse of Psychological disorders.