Expressed emotion: Relevance to rehospitalization in schizophrenia over 7 years
Expressed emotion: Relevance to rehospitalization in schizophrenia over 7 years
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DOI：
10.1093/schbul/sbi016
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发表时间：
2005-07-01
影响因子：
6.6
通讯作者：
Hermesh, H
中科院分区：
文献类型：
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作者：
Marom, S;Munitz, H;Hermesh, H
情绪表达（EE）是精神分裂症短期复发的一个确定因素。然而，关于其长期预测能力的数据很少。我们将短期调查延长至7年随访。研究人群包括108名患者，其中93名患有精神分裂症，15名患有分裂情感性障碍。使用五分钟语音样本（FMSS）对关键亲属的情感表达进行评分。通过情感表达及其两个组成部分：批评（CR）和情绪过度投入（EOI）对患者家庭进行分类。高CR与较早的第一次和第二次再入院相关（Breslow p分别= 0.002和0.04）。与低CR相比，高CR与更高的再入院率（p = 0.01）和更长的住院时间（p = 0.02）相关。药物治疗的依从性以及高CR与低依从性的相互作用是导致首次再入院时间的额外因素。这项研究首次证明了情感表达的长期预测效度。我们的结果支持CR作为精神分裂症病程预后指标的价值。FMSS在精神病住院方面似乎具有预测能力。旨在降低高情感表达的治疗方法似乎可以作为长期的预防方法。
Expressed emotion (EE) is an established factor in short-term relapse in schizophrenia. However, data on its long-term predictive ability are scarce. We extended our short-term investigation over 7 years' followup. The study population consisted of 108 patients, 93 with schizophrenia and 15 with schizoaffective disorder. EE of the key relatives was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism (CR) and emotional overinvolvement (EOI). High CR was associated with earlier first and second readmissions (Breslow p = 0.002 and 0.04, respectively). High CR was associated with a higher rate of readmissions (p = 0.01) and a longer hospital stay (p = 0.02) compared with low CR. Both compliance with pharmacotherapy and the interaction of high-CR x poor compliance were additional contributors to time to first readmission. This study is the first to demonstrate the prolonged predictive validity of EE. Our results support the value of CR as a prognostic indicator of the course of schizophrenia. The FMSS appears to have predictive power in respect to psychiatric hospitalization. Therapies aimed at lowering high EE seem warranted as a long-term preventive approach.