Family Attitude Scale Research Articles

FC25: Family Caregivers’ Perceptions of Expressed Emotion Toward Dementia Patients: A Qualitative Descriptive Study

Objectives: This study aims to explore the perceptions of family caregivers regarding their expressed emotions (EE) towards dementia patients and to identify factors associated with high and low EE.Methods: We conducted qualitative descriptive research through semi-structured interviews with 64 family caregivers of dementia patients, regardless of cohabitation status, from 2021 to 2022. Each caregiver participated in three one-hour interviews over three months. We used the Family Attitude Scale (FAS), a validated 30-item, 5- point Likert scale, to measure EE. Higher scores indicate more critical emotions toward the dementia patient, with a maximum score of120. Based on expert advice and data distribution, we set a cutoff point at 40; scores above 40 indicate high EE, while scores of 40 or below indicate low EE. Interviews focused on the caregivers’ challenges, sources of encouragement, and support systems. Transcripts were analyzed using thematic analysis. The study received approval from the Clinical Research Ethics Committee of Osaka University Future MedicalCenter.Results: High EE caregivers (scores above 40) reported themes such as: poor pre-existing family relationships, lack of a confidant, severe behavioral and psychological symptoms of dementia (BPSD) in the patient, unemployment, low self-esteem, involvement in toileting assistance, inadequate explanations from physicians, and a tendency to reject public support. Additional themes included feelings of frustration and helplessness, lack of emotional support from other family members, and increased caregiver burden due to high care demands. In contrast, low EE caregivers (scores of 40 or below) highlighted themes including: respect for the care recipient, having multiple confidants, mild BPSD in the patient, employment, cooperation from supporters, and a sense of gratitude for caregiving. Further themes identified in this group were effective communication with healthcare professionals, active engagement in caregiver support groups, higher levels of resilience and coping strategies, and a positive outlook on the caregiving role as a meaningful and rewardingexperience.Conclusions: The study identified distinct factors associated with high and low EE among family caregivers of dementia patients. Understanding these factors can help tailor interventions to support caregivers, improve their emotional well-being, and enhance the quality of care for dementia patients.

Exploring expressed emotion and its influencing factors among family caregivers of dementia people: a 3-month study in Japan.

Family caregivers of dementia patients face significant challenges, including managing their own emotional responses. Understanding factors influencing expressed emotion (EE) is crucial for effective support interventions. The aim of this study was to explore and describe changes in EE among family caregivers of dementia and its associated factors at different time points over 3 months. A 3-month observational study was conducted in Japan. We collected demographically detailed data on family caregivers currently providing care, including care burden, relationship closeness, and depression. We assessed EE using the validated Family Attitude Scale (FAS). After adjustment for multiple confounding factors, multivariate linear regression analysis was performed to assess factors affecting EE at various time points. Linear regression analysis with generalised estimating equations was used to assess associations between 3-month time-varying EE and burden, intimacy, and depression. Fifty-six family caregivers completed the study. Changes in FAS scores did not show statistical differences over 3 months. It is worth noting that the degree of relationship closeness and care burden are important influencing factors of EE in both cross-sectional analysis and longitudinal analysis. Early identification of risk factors can aid in developing interventions aimed at preventing high levels of EE in the dementia family, thereby mitigating their detrimental effects. Tailored interventions are essential to enhance caregiver well-being and cultivate positive caregiver-patient relationships.

Role of Expressed Emotions and Its Impact on Relapse in Bipolar Affective Disorder

Abstract Background: The role of expressed emotions (EEs) in relapse is poorly understood in bipolar affective disorder (BPAD). Understanding the association between EE and relapse will be useful in predicting further relapse and improving the prognosis. Aims and Objectives: The present study was conducted with the objectives of assessing the relationship between EEs of caregivers and relapse of the illness in patients with BPAD on regular medication and to assess the relationship between severity of illness and EEs. Materials and Methods: Fifty consecutive bipolar disorder patients diagnosed as per the International Classification of Diseases-10 criteria, who were admitted into the department of psychiatry with relapse while on regular medication, and their caregivers were recruited into the study. Data were collected using a semi-structured pro forma designed for the study. Clinical details of illness were obtained from the informant and the records. The severity of the current episode was assessed with the rating scales (Young Mania Rating Scale and Hamilton Depression Rating Scale). The Expressed emotions(EE) among the caregivers were assessed using the Family Attitude Scale, association between EE and relapses as well as the severity of illness was analyzed with appropriate tests. Results: The mean age of the patients was 43.8 ± 15.4. Majority of them were male and married (68% and 68%). The mean age of the caregivers was 47.1 ± 10.5. The majority of the caregivers were female (60%). Sixty-four percent of the caregivers had high EEs. The mean age of onset of illness was 26.2 ± 4.6, and the number of previous episodes was 3.9 ± 2.5. The total duration of illness was 17.7 ± 13.4 years, and the number of previous admissions was 3.3 ± 2.2. Among clinical variables of patients and caregivers with high EEs, a significant association was found between duration of illness (Chi-square test: 11.82, P = 0.003), previous episodes (Chi-square test: 12.26, P < 0.01), and the number of previous admissions (Chi-square test: 9.79, P = 0.002). Conclusion: There was a significant association between high EE and relapse.

Quality of Life and Expressed Emotion in Caregivers of Patients with Psychiatric Disorders

Abstract Background Caregivers form an integral part of the psychosocial management of patients with psychiatric conditions. Caregivers of patients with major psychiatric disorders feel burdened, as these disorders are unpredictable and long lasting. The study was aimed to assess the quality of life (QOL) and expressed emotion among caregivers of patient's with psychiatric disorders. Materials and Methods A cross-sectional descriptive design was adopted for the study. The sample consisted of 300 caregivers of psychiatric patients who visited psychiatric outpatient department and inpatient department of selected hospital. The caregivers were selected by using convenient sampling technique. Baseline proforma, the World Health Organization Quality of Life Scale (WHO QOL BREF), and Family Attitude Scale were used to collect the data. Results Descriptive and inferential statistics were used to analyze the data. The analysis revealed that there was a weak negative correlation between QOL and expressed emotions. The obtained “r” value (−0.14) was statistically not significant at 0.05 level of significance. Hence, the research hypothesis was rejected and the null hypothesis was accepted. Conclusion The study concluded that there was a low negative correlation between QOL and expressed emotions. The obtained “r” value (−0.14) is statistically not significant at 0.05 level of significance. But there was association between QOL and income and occupation of the caregiver.

PRELIMINARY FINDINGS OF A STUDY ON LONGITUDINAL CHANGES IN EXPRESSED EMOTION IN FAMILY CAREGIVERS WITH DEMENTIA

Abstract Purpose The aim of this study was to explore and describe changes in expressed emotion (EE) among family caregivers of dementia and its associated factors at different time points over 3 months. Method: A longitudinal observation study using a 3-month survey was conducted in home care settings, Japan. We collected data on the demographic details of family caregivers currently providing care, which included care burden (Zarit Burden Inventory, ZBI), closeness of the caregiving relationship (Relationship Closeness Scale, RCS), depression (Geriatric Depression Scale, GDS). We used the validated Family Attitude Scale (FAS) to assess EE, in which higher scores indicate a greater intensity of emotional expression. Results To date, 45 family caregivers completed the present study. FAS scores were 39.67 ± 24.90 at month 1 (T1), 38.64 ± 23.28 at month 2 (T2), and 39.69 ± 24.52 at month 3 (T3). The change in FAS scores did not show a statistical difference over the three-month period (p=0.816). Multiple regression analysis of FAS at T1 showed that the main influencing factors were gender, marriage, RCS, care burden, and depression (R2=0.763, p < 0.001); the main influencing factors at T2 were marriage and care burden (R2=0.584, p < 0.001); the main influencing factors at T3 were care burden and depression (R2=0.674, p < 0.001). Conclusions: Early identification of risk factors may help in the development of interventions to prevent high levels of EE in family caregivers. We plan to continue refining our analyses to test the validity of our hypothesis.

Factors Affecting the Family Attitude Toward the Outpatients With Schizophrenia

Objectives: To identify various factors that might affect a high expressed emotion recognized by primary caregivers of the schizophrenic outpatients.Methods: Of patients who had been receiving outpatient treatments at department of psychiatry of Dong-A university hospital, 154 patients with a DSM-V diagnosis of schizophrenia with stable symptoms and their primary caregivers were enrolled in this study. Family attitude (family attitude scale) was assessed through an interview with primary caregivers. In these patients, symptoms (brief psychiatric rating scale), problem behavior (behavior and symptom identification scale), general health status (shortform 36 health survey), recovery (recovery assessment scale), drug attitude (drug attitude inventory), insight (self-appraisal of illness questionnaire) were assessed through a self reporting questionnaire. Multiple regression analysis were performed in consideration of 15 factors (age, sex, the level of education, marital status, job status, age of onset, duration of illness, number of hospitalization, chlorpromazine equivalent dose, symptoms, problem behavior, general health status, recovery, drug attitude, insight) as explanatory variables for a family attitude.Results: On a multiple regression analysis, the following five factors were found to be significant explanatory variables for a family attitude that is experienced by primary caregivers of the schizophrenic outpatients: job status, duration of illness, number of hospitalization, problem behavior, and drug attitude. A coefficient of determination for these five explanatory variables was 0.58. The high expressed emotion group had significantly higher number of hospitalizations and problem behavior, but lower employment, poorer genral health status, negative drug attitude, and lack of insight compared to the low expressed emotion group.Conclusion: Our results showed that five factors such as job status, duration of illness, number of hospitalization, problem behavior, and drug attitude were found to be significant explanatory variables for family attitude that is experience by primary caregivers of the schizophrenic outpatients. Because these five variables account for 58% of total family attitude, however, further studies are needed to identify other factors that might affect a family attitude.

РЕЦИПРОКНІСТЬ ЕМОЦІЙНОЇ ЕКСПРЕСИВНОСТІ У ТРІАДІ «КОРИСТУВАЧ МЕДИЧНИХ ПОСЛУГ-РОДИНА- МЕДПРАЦІВНИК»

The paper aims to explore theoretically and empirically the reciprocity of expressed emotion (EE) in the interaction of medical service users with chronic gastrointestinal diseases, their relatives and healthcare staff. The key research question was whether the objective emotions expresses by relatives and healthcare staff coincided with subjective EE experienced by medical service users. The study applied methods of theoretical analysis, as well as measures, represented by scales and questionnaires for empirical research, including the Health-Related Quality of Life Questionnaire (EQ-5D-3L), the Level of Expressed Emotion Scale (LEE), the Family Attitude Scale (FAS), the perceived Expressed Emotion in Staff Scale (pEESS). According with the goal, the study aimed to solve the following research questions: Are there any correlations (as markers of EE reciprocity) between EE as the family's objective attitude to a diseased medical service user and the user's subjective experience of such family's and healthcare staff's attitude to him/her? Can the family attitudes towards a medical service user with chronic gastrointestinal diseases, the subjective experience of this attitude by the medical service user (perceived emotions expressed by the relatives), the user's subjective experience of the healthcare staff's EE and the user's health condition become predictors of disease-related quality of life? Are there any differences in health condition and disease-related quality of life according to the status of a family member (a partner/other relative)? The study results indicate that there were significant correlations between the perceived EE as a marker of subjective experiences of relatives' EE and objective family attitude towards medical service users. The findings also indicate correlations between family member's and healthcare staff's EE as it was perceived by medical service users. These results showed the reciprocal character of EE as a marker of a diseased individual's family environment. The results of the linear multiple regression showed that FAS as a marker of the family's attitude towards medical service users and users' health condition were significant predictors of life quality related to gastrointestinal diseases. There were significant differences between the objective family attitudes towards medical service users depending on caregivers' family status, in particular, FAS was higher in partners compared to other caregivers.

Family Attitude toward the Persons with Negative Symptoms of Schizophrenia

Background: Negative symptoms of schizophrenia not only lead to poor interpersonal relationship, impaired social and work functioning of the clients but it also affects family members in various aspects. The present study aimed to assess the attitudes of the primary caregivers toward the clients with negative symptoms of schizophrenia. Materials and Methods: A cross-sectional study was conducted at tertiary care hospital of Assam. Through purposive sampling technique, 40 primary caregivers of clients with negative symptoms of schizophrenia were selected from the indoor setting of a tertiary mental care institute. Self-structured sociodemographic and clinical Proforma, Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), and Family Attitude Scale (FAS) were used to collect the data. Data were analyzed using the descriptive and inferential statistics. Results: Majority of the participants (87.5%) score <60 in the FAS which showed low expressed emotion toward the clients with negative symptoms of schizophrenia. A significant negative correlation was found between the SANS score and monthly income of the clients (r = -'0.446, P = 0.004). Conclusion: Attitude of the primary caregivers toward the patient may vary based on the symptoms of schizophrenia. Assessing their attitude in the form of expressed emotion may help to understand their perception during the care of patients with negative symptoms of schizophrenia. This may help to plan suitable psychosocial nursing care for the primary caregivers.

Effectiveness of family-focused psycho-education on expressed emotions among caregivers of persons with bipolar affective disorder: An interventional study

Background: Expressed emotion (EE) is a significant characteristic of the family milieu that has been found to predict symptom relapse in bipolar affective disorder (BPAD). The need for family-focused psychosocial intervention in BPAD suitable to our culture is poorly understood. Therefore, this study was designed to discover the effectiveness of Barcelona family-focused group psycho-education on EE in BPAD.Aim: The aim of the present study is to assess the effectiveness of family-focused psycho-education on EE among caregivers of patients with BPAD.Materials and Methods: The interventional study included forty primary caregivers of patients diagnosed with BPAD. Caregivers were randomly allocated into five groups of eight each. BPAD was diagnosed by using the International Classification of Diseases-10, Classification of Mental and Behavioral Disorders, and Diagnostic Criteria for Research. The researcher had used the purposive sampling technique. Assessed EE by administering Family Attitude Scale (FAS) at pre- and postinterventional phases, family-focused group psycho-education module of Barcelona was adopted as an interventional method.Results: Totally 23 (57.5%) male and 17 (50.75%) female caregiver respondents participated in the study. The mean value of the overall pretest FAS score of total respondents was 94.33, critical comments = 43.75, hostility actions = 29.98, and distancing = 28.53. With EE dimensions, a greater difference in pre-intervention mean of 94.33±8.48 and a post-intervention value of 37.28±13.07 could be observed (t = 25.20, P = 0.001 and P< 0.05, respectively).Conclusion: Barcelona family-based psycho-educational intervention model is effective in reducing higher EE in families of patients with BPAD.

Effectiveness of Psychosocial Nursing Care on Negative Symptoms, Quality of Life of Persons with Schizophrenia and Attitude of the Primary Care Givers Towards the Patient: A Pilot Report

Schizophrenia is a major mental disorder with varied symptoms like positive, negative and cognitive symptoms. These symptoms blow the client and their family members in various ways. Becoming dependent on the family members, inability to take the family roles and responsibilities, unproductive life create burden for the families and depreciate the quality of life of the clients. Psychopharmacological agents along with the psychosocial interventions knotted together were found to be valuable for the treatment of these symptoms. A quasi-experimental design was conducted with the aim to find out the effectiveness of psychosocial nursing care on negative symptoms, quality of life of the persons with schizophrenia and attitude of primary care givers towards the patient. Socio demographic & clinical pro forma, family attitude scale and WHOQOL-BREF were used to measure the variables. Psychosocial nursing care was implemented for both the clients and primary care givers for experimental group. Negative symptoms were assessed before the intervention, just after the intervention and at one month after the intervention. Family attitude and Quality of life were assessed before and one month after the intervention. Same process was adopted for control group without the intervention. The experimental group showed a significant statistical difference in negative symptoms at pre test, first post test and second post test following psychosocial nursing interventions F=137.87(2),p 0.05.No significant difference in quality of life score was found in the post test score for both the group. The findings from the study showed that along with the psychotropic medications various psychosocial nursing interventions were effective to reduce the negative symptoms. However, further studies with larger sample size may provide better inference for the effectiveness of psychosocial nursing care

Quality of Life of Patients with Wilson's Disease and Their Families

Wilson's disease (WD) is a chronic disease caused by altered copper metabolism requiring lifelong therapy. Its long-term and debilitating nature has the potential to affect the quality of life (Qol) of patients as well as their families. Our study aims to assess this impact of the disease on patients and their families. We conducted a prospective, observational study over 2 years on 73 patients and 73 age-matched controls with 33 children and 40 adults in each group. The Qol of cases and controls was assessed using the PedsQLGeneric Core Scales and World Health Organisation Quality of Life BREF (WHOQOL-BREF) for children and adults, respectively. Families of child and adult patients were interviewed using PedsQLFamily Impact Module and Family Attitude Scale (FAS), respectively. The data were statistically analyzed. Mean age of the cases was 22.04±11.8 years. Qol scores for both adults and children were worse in cases with neuropsychiatric disease than in those with hepatic disease. For children, the mean scores of overall psychological functioning were lower in cases compared with controls (P=0.0001). Qol of parents of the patients was significantly lower than those of parents of the controls as was the family functioning (P=0.0001 and P=0.016). Family Attitude Scale scores for adults did not differ significantly between cases and controls. The Qol of patients with neuro-WD is worse than that of hepatic disease. The disease impacts the psychological functioning of the children and the Qol of their families, which improves with the duration of the disease. WD is a long-term, debilitating disease. Patients have to take lifelong treatment with frequent medical visits and often multiple hospitalizations. WD affects the Qol of not only the patients but also their families. Qol of patients with neuro-WD is worse than that of patients with hepatic disease.

Gambaran Sikap Keluarga Terhadap ODS (Orang Dengan Skizofrenia) Di Desa Kertajaya Kecamatan Cibatu Kabupaten Garut

People with schizophrenia (PWS) certainly need a role of family as people closest. The relapse in people with schizophrenia is greatly influenced by family attitudes, at this time there are still many families incorrectly behaving like stay away, hostile, avoid and hates the patient on the grounds of shame eventually worsen the condition of PWS. The purpose of this study is to determine family attitudes towards PWS in Kertajaya Village, Cibatu Sub-District, Garut District.Research method used in this study is quantitative descriptive with a population of families who have PWS in Kertajaya Village, Cibatu Sub-District, Garut District. Samples are obtained using total sampling techniques with the total of 43 family members. The instrument used in this study is the Family Attitude Scale (FAS) questionnaire with the validity value (0.413-0.812) of r count ? 0.329. Reliability test with the value of 0.89. The results of this study show that in terms of the family attitude toward PWS, of 43 respondents, 22 family members (52.2%) perform attitude categorized as positive attitude and 21 (48,8%) negative. The family attitude included in positive category may be due to sufficient knowledge background, the role of good health workers. While the negative one may be due to exhaustion and disappointment because of the condition of PWS. This research results

The Relationship between Family Attitude and Family Caregiver Burden of Patients with Schizophrenia in Tangerang

Introduction: Schizophrenia is a mental disorder that occurs in the long term and affects the thought process which demanding for the required care. Negative attitudes can be one of the factors that influence the family burden that is getting heavier. This study aimed to determine the relationship of family attitudes to the family burden of caring for schizophrenic patients at the psychiatric hospital in Kota Tangerang. Methods: The study was a descriptive correlation with Cross-Sectional design. The population of this study was the family caregivers of patients with schizophrenia who visited the psychiatric clinic at Kota Tangerang Hospital. This study used the accidental sampling method, recruited as many as 64 people. The instrument of this study was the Burden Assessment Schedule (BAS) questionnaire and the Family Attitude Scale (FAS) had been examined the validity and reliability test. The Chi-square test was used for the statistical analysis to identify the relationship between family attitude and caregiver burden. Results: The results of this study were 23 respondents who had a positive attitude with a light burden of 52.2% while those with a negative attitude had 41 respondents with a heavy burden of 80.5. The p-value was 0.007 showed that there was a significant relationship between family attitudes and the burden of the family caring for patients with schizophrenia in psychiatric hospitals in Kota Tangerang Hospital. Conclusion: It suggests that health care providers need to consider the burden perceived by the caregivers so they are more likely to show a positive attitude in providing care for the beloved-one.Keywords: Caregiver Burden, Family Attitudes, Family Caregivers, Patients with Schizophrenia

Postawy rodzicielskie małżonków o wyższym i niższym poziomie samoakceptacji

The study involved 75 families were examined using The Adjective Check List (ACL) by H.G. Gough and A.B. Heilbrun and Family Attitude Scale by M. Braun-Gałkowska. Mothers with a lower level of self-acceptance were more often characterized by an excess of requirements than mothers with a higher level of self-acceptance. The examined children attributed to mothers with a lower level of self-acceptance, much more often the excess of management, than mothers with a higher level of self-acceptance. Fathers with a lower level of self-acceptance were more often characterized by an excess of help than fathers with a higher level of self-acceptance. The obtained results indicate that parental attitudes expressed by the spouses with a higher level of self-acceptance more frequently than the parental attitudes of spouses with a lower level of self-acceptance are characterized by moderation in all dimensions of the parental attitude, which characterizes the proper parental attitude conducive to the proper development of children.

Symptoms, course of Illness, and comorbidity as predictors of expressed emotion in bipolar disorder

High levels of expressed emotions (EE) reflect the amount of criticism and/or over-involvement in families and has been linked to relapse risk in various psychiatric disorders including bipolar disorder (BD). Less clear is which factors contribute to the development and/or maintenance of EE. Therefore, we tested whether patient characteristics, specifically clinical features and personality disorder traits in BD predicted key aspects of EE as assessed by patients and their relatives. Patients with remitted BD and their relatives were asked to complete the Family Attitude Scale (FAS) and the Perceived Criticism Measure (PCM). Patient characteristics were assessed with a variety of measures including SCID I and II. The FAS and PCM shared 25% of the variance for patients and 14% for relatives, suggesting a conceptual overlap, but they may not assess identical constructs. The number of previous mood episodes, current self-rated manic symptoms, and comorbid symptoms of Cluster C personality disorder predicted patient-rated FAS. Relative-rated FAS was only predicted by comorbid symptoms of Cluster A personality disorder. In BD, specific patient characteristics seem to be linked to key aspects of EE even when in remission. However, it might depend whether the patient, his/her relative, or a neutral observer assessed EE.

A study to assess the relationship between stigma and expressed emotion among the primary care givers of persons with schizophrenia attending outpatient department of Lokopriyo Gopinath Bordoloi Regional Institute of Mental Health, Tezpur

Background: Mental illness is a condition that impacts a person's thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. Among various types of mental illnesses schizophrenia is common disorder affecting approximately 1% of any given adult population. Stigma surrounding schizophrenia restraints the patient and family members to access the treatment facilities and type of support they need to manage their illness. It can also disturb the family environment which can often give rise to expressed emotion. Expressed emotion refers to a global index of particular emotions, attitudes and behaviours expressed by relatives of a family member diagnosed with schizophrenia. Aims and Objectives: The aim of the study was to assess the relationship between stigma and expressed emotion among the primary care givers of persons with schizophrenia. Materials and Methods: Descriptive co relational research design was used. The sample comprised of 60 primary caregivers of persons with schizophrenia attending OPD of LGBRIMH, Tezpur which was selected by using purposive sampling technique. Two standardized tool (Stigma subscale of Family Interview Schedule and Family Attitude Scale) and socio demographic data sheet was used for patient and primary care giver. Results: Finding showed majority of the sample i.e. 65% (n = 39) obtained the stigma score below 10.83 (mean score) and only 35% (n = 21) obtained the stigma score above10.83 (mean score).This finding showed that majority of the primary care givers has low stigma having a patient with psychiatric illness in their family. It was also showed that majority of the sample i.e. 66.7% have obtained expressed emotion score below 29.68 (mean score) and 33.3% have obtained expressed emotion score above 29.68 (mean score).This finding showed that the majority of the primary care givers has low expressed emotion towards a family member having schizophrenia. There was significant positive correlation found between stigma and expressed emotion among the primary care givers of persons with schizophrenia (calculated value was found to be 0.587 which was higher than the tabulated value at 0.01 level of significance). Conclusion: It showed that if stigma increases, the expressed emotion among the primary care givers towards the patient also increases.

Characteristics of Parents With High Expressed Emotion and Related Factors: A Study of Parents of Adults With Schizophrenia.

This study aimed to clarify characteristics of parents with high expressed emotion (EE) and related factors among parents of adults with schizophrenia. In total, 73 (25.3%) of the 289 parents had high EE (Family Attitude Scale [FAS] score ≥60), and 216 (74.7%) had low EE (FAS score <60). A multiple logistic regression analysis showed that high EE parents were more distressed (odds ratio [OR] = 1.27; 95% confidence interval [CI] = 1.16-1.39) and experienced more physical violence from their adult children with schizophrenia (OR = 2.86; 95% CI = 1.28-6.43); the children with schizophrenia had been hospitalized at time of survey (OR = 6.54; 95% CI = 1.10-38.89) and were less likely to attend rehabilitation services (OR = 2.56; 95% CI = 1.06-6.17). Practitioners need to provide crisis intervention, home-visiting services, and support services for parents during hospitalization of their children with schizophrenia.

Expressed Emotion and Its Relation with Anxiety in Caregivers of Psychiatric Patients

Expressed Emotion (EE) of the caregiver is one of the critical factors that contribute relapse of the psychiatric patient during and after treatment. Living with psychiatric patients could result in subjective burden and is usually associated with distress and stigma. Predisposing anxiety of the caregiver influences the recovery process of the mental illness. Less attention has been paid to the antecedent factors that contribute to EE of the family members. The present study was conducted to investigate the relationship between EE and anxiety, which in turn help to understand role of caregivers in the intervention process of psychiatric patients. Materials and Methods: Data were collected from 150 caregivers attending outpatient department of psychiatry, Regional Institute of Medical Sciences , Manipur, regarding socio-demographic characteristics (e.g., age, gender, domicile) using socio-demographic performa, followed by Family Attitude Scale and Taylor’s Manifest Anxiety scale form caregivers of different psychiatric patients. Descriptive statistics such as mean and standard deviation (SD) and chi square for categorical data were used. ANOVA test was also applied to compare the means of different groups. Results: Among the socio-demographic variables, statistically significant difference (P=0.002) was between monthly family income and EE of caregivers. High significant relationship was also observed between EE and level of anxiety (p=0.000). Among the different psychiatric patients, highest mean score of EE was observed in Substance related disorders (mean=49.44) followed by Psychosis NOS (mean=39.6,and significant relationship was observed between different types of psychiatric illness and level of EE(p=0.002). Insignificant relationship was observed between the duration of illness and EE. Conclusion: An avenue has opened up to understand the role of family as an important resource towards intervention of psychiatric illness as well as the role of significant amount of EE and level of anxiety among caregivers indicates the need for psychosocial support to the family members for the mitigation in the EE and reduction of associated anxiety which in turn could reduce the number of relapse rates and facilitates the caregivers to manage and cope effectively with psychiatric illness.

Factors influencing confabulation in Japanese patients with Alzheimer's disease.

Confabulations are often observed in patients with Alzheimer's disease (AD) and can increase family caregivers' burdens. Previous studies have focused on the relationship between confabulation and cognitive ability. However, few studies have investigated the association between confabulation and familial factors. Here, we aimed to examine whether confabulation relates to familial factors, such as the level of family caregivers' expressed emotion or the level of functioning of the family. Twenty-seven outpatients with AD and their family caregivers participated in this study. We examined confabulations about episodic memory, semantic memory, and future planning using the Modified Confabulation Battery (MCB). We investigated correlations between scores on the MCB and scores on the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Family Attitude Scale (FAS), and the Family Adaptability and Cohesion Evaluation Scale. Multiple regression analyses were performed using the total scores on the MCB and domain-specific scores on the MCB as dependent variables, and the scores on the MMSE, GDS, and FAS as independent variables. MCB scores were positively related to FAS scores (P < 0.01) and negatively to GDS scores (P < 0.05), but not to MMSE scores. Regarding the three domains the MCB measured, confabulation about episodic memory and future planning showed a positive relationship with FAS scores. Family attitude was the factor most related to confabulation in our study. Patients with AD may attempt to avoid confronting family caregivers' high emotional expression through confabulation, or confabulation itself might result in high emotional expression among family caregivers. Psychoeducational or therapeutic approaches for family caregivers might reduce confabulation in patients with AD.

Hostility and emotional load of Tunisian caregivers of Alzheimer patients and its impact on the patient

Introduction The studies on Alzheimer disease highlight the family caregivers burden and his consequences on hostility. Few authors study the burden and the mental health of the caregivers of a demented relative. Aims This study aims at assessing the hostility and emotional load of caregivers of Alzheimer patients and determining the relation between the burden and the psychic health caregivers and its impact on the patient. Methods It is a descriptive cross-sectional study. Patients were recruited from the neurology department of Razi hospital Tunisia between January and June 2013. Consenting caregivers participating in the study were interviewed with a structured survey focused on their socio-demographic characteristics, the characteristics of the aid relationship and the emotional burden felt valued by the Family Attitude Scale (FAS). Results The caregiver was in nearly 60% a child. He lived under the same roof in 78.3% of cases. In 65% of cases, it passes between 12 and 24hours with the patient. FAS score was 52.4±16.16. Thirty-five percent of caregivers had a significant emotional burden (score>60). FAS score was not correlated with the age of the helping relationship, cohabitation with the patient or the number of hours spent with him. The children had a greater emotional charge than spouses ( P =0.001). The wickedness against the patient and abuse, the desire to institutionalize were related to the importance of the emotional charge ( P Conclusions These hostile thoughts are mostly directed against the patient but it can also be directed against oneself causing depression and guilt.