The course of parental expressed emotion and psychotic episodes after family intervention in recent-onset schizophrenia. A longitudinal study

Abstract

The stability of parental expressed emotion (EE) is analysed over about 9 years, and related to course of illness in patients with recent-onset schizophrenia. Families, who participated in a 15-month intervention, were randomised over two intervention conditions. Psychotic episodes were measured over 5 years after discharge. The Five Minute Speech Sample (FMSS) EE was elicited two times during the 12-month outpatient intervention and two times over 8 years after discharge on average. EE is expressed as criticism/dissatisfaction (CRIT), emotional overinvolvement (EOI), and as the classical dichotomous index. EE is not stable over the years. Intervention condition had no differential effect on EE as measured with CRIT and the dichotomous index. For EOI, an interaction between intervention condition and time was found. EE as assessed during intervention does not predict psychotic episodes during follow-up. An association was found between psychotic episodes and CRIT as assessed at 34 months after discharge. Family intervention may inhibit the development of high EOI for a limited period. Our results may be in support of the hypothesis that psychotic episodes in patients can affect the critical attitude in parents.