Expressed emotion (EE)

• What is EE?

  EE is when families persistently exhibit negative emotions (criticisms & hostility).
• Elements of EE

  Verbal criticism, sometimes accompanied by violence.

  Hostility towards the child / patient, including anger & rejection.

  Emotional over-involvement in the life of the child / patient. High levels of happiness and sadness, extreme over-protectiveness of caregiver.
• Brown

  Brown discovered that patients who were discharged from psychiatric care into households with high EE were often readmitted due to relapse.

  He assessed EE by measuring:

  Frequency of critical comments made towards patient.

  Number of statements of dislike & resentment towards the patient.

  Number of statements reflecting over involvement or over protectiveness towards patient.

  EE has been associated with high relapse rates & rarely results in the onset of SZ symptoms.
• Butzlaff & Hooley

  Reviewed over 200 studies of EE & found that 70% of SZs in families with high EE relapsed within a year compared with 30% of those with families with low EE.

  Suggests reducing the levels of EE in families with a SZ member may significantly reduce relapse rates.