Effect of caregivers’ expressed emotion on the care burden and rehospitalization rate of schizophrenia

Abstract

BackgroundThis study assessed the effect of expressed emotion (EE) among caregivers of schizophrenia patients on their care burden and the illness rehospitalization rate.Subjects and methodsA total of 64 schizophrenia patients hospitalized for the first time and their key caregivers were recruited. The Chinese version of the Camberwell Family Interview (CFI-CV) was used to evaluate the EE of the key caregivers. A family burden questionnaire was used to evaluate the care burden. The patients’ rehospitalization rate and medication compliance were evaluated by the self-designated criteria. The data collection was carried out at the first meeting in the hospital, at 6 months and 12 months after hospital discharge by using the same instruments.ResultsThe subjective stress burden and subjective demand burden scores were higher in caregivers before and after discharge with statistical difference between the various observation time points (P<0.05). Significant differences were observed in the rehospitalization rate between patients with high medication adherence and low medication adherence at 12 months (P<0.01) and between patients with high expressed emotion (HEE) and low expressed emotion (LEE; P<0.05). The rehospitalization rate in patients with HEE caregivers was higher than that in those with LEE caregivers. The subjective stress burden scores were statistically significant between HEE and LEE caregivers (P<0.05).ConclusionHEE is a predictor of rehospitalization rate in schizophrenic patients. The burdens of care scores are high in caregivers of schizophrenic patients. The caregivers with HEE have a high score in burden of care compared with those with LEE.

The Relationship of Relatives’ Illness Perception, Expressed Emotion and Their Burden in Caring for Patients with Schizophrenia

“…Mental illness is upsetting and disabling conditions for patients which, in turn, causing a severe burden for their family and society [21]. Caring for a family member with schizophrenia has day-to-day challenges and requires adjustments on the part of relatives, especially in the first-onset of the illness.…”

Assessment of Burden Among Family Caregivers of Schizophrenia: Psychometric Testing for Short-Form Zarit Burden Interviews

“…Concurrent validity was measured using Spearman correlations with expected significant negative correlations with patient's function (GAF score), as well as significant positive correlations with caregiver's depression (PHQ-9 score), and anxiety symptoms (GAD-7 score) (Ji et al, 2014; Wang et al, 2017; Sun et al, 2018; Yu et al, 2018). We further performed Fisher r-to-Z test to compare the statistical significance of different correlations.…”

Expressed emotion (EE) in families of individuals at-risk of developing psychosis: A systematic review

“…Previous studies have indicated that within the psychosis population, high-EE is a predictor of relapse and rehospitalisation. Several studies have explored the needs, perceptions and mental health of carers supporting these individuals and found that high-EE is associated with high carer burden (Wang et al, 2017). Family members experiencing high burden were more likely to have higher levels of anxiety and depression and financial impairment (Barrowclough et al, 1996;Jansen et al, 2015).…”

“…Psychosis literature found that high-EE was associated with both higher carer burden and distress in family members" health (Wang et al, 2017;Jansen et al, 2015). Considering that family members of ARMS reported high levels of worry and concern (Wong et al, 2008), one may expect to see high-EE have a negative impact for ARMS families" health.…”