SUMMARYObjective: Psychopathological symptoms presented by fibromyalgia patients include introversion, inability to reflect emotional needs, lack self-esteem, and inefficiency in social relationships. There are measures to assess the relationship of the expressed emotion of patients and spouses with severity of fibromyalgia syndrome (FS). The aim of this study to assess the effect of expressed emotion of patient (LEE) and her spouse (EE) on the severity of FS in women. Method: 123 FS patients and 105 healthy controls enrolled for the study. In the study, fibromyalgia impact questionnaire (FIQ), Montgomery-Asberg Depression Rating Scale (MADRAS), and level of expressed emotion (LEE) and expressed emotion (EE) were recorded. Results: LEE in FS was significantly higher than that in healthy controls [15 (2-56) vs. 11 (3-38); p<0.05]. The EE in FS was significantly higher than that in healthy controls (14.2±4.3 vs. 12.4±4.2; p<0.05). The FIQ score had mild correlations with LEE and EE, place of residence, and family history of FS (r=0241, r=0183, 0.214, and 0.203; respectively) but not with education status, family type, MADRAS score, number of tender points, and duration of FS (p>0.05). After linear hierarchical regression analysis was done to determine to the interaction of EE on the relationship of LEE and FIQ scores, there was no statically significant interaction of EE on the relationship of LEE and FIQ scores (p>0.05). Conclusions: The findings of this study support the value of assessment of EE from the perspective of patients and their spouses during the management of FS.