Mood disorders and expressed emotion (EE) of families

点击翻译按钮获取中文摘要

The reliability of expressed emotion (EE) ratings by Camberwell Family Interview (CFI) and characteristics of EE were evaluated in families of patients with mood disorders in Japan. The subjects were 27 patients with mood disorders and 31 members of their families. Concerning critical comments (CC), hostility (H), and emotional overinvolvement (EOI), which are important for EE rating, Spearman's correlation coefficient and the kappa value were 0.4 - 0.8, and the reliability of EE ratings in mood disorders was not high. The proportion of positive agreement was particularly low in H and EOI.CCs were fewer in families of Japanese patients with mood disorders than in those with schizophrenia or families of American or European patients with mood disorders. Re-evaluation of the infer-rater reliability of EE ratings in mood disorders is needed. Expressed emotion was more suppressed in families of patients with mood disorders than in those of patients with schizophrenia.The subjects were 32 p … More atients diagnosed to have mood disorders on the basis of DSM-IV and ICD-10 and 36 principal members of their families. The families of the patients were interviewed by CFI within 2 weeks after admission of the patients, and EE was evaluated. A cohort study was conducted by following up the subjects for 9 months after discharge of the patients. The patients were divided into a high-EE group and a low-EE group using a few cut-off points concerning the number of CCs and EOI, the risk of relapse during the 9 month was compared, and the relapse risk ratio and its 95% confidence interval were calculated. Also, the sensitivity, specificity, positive predictive value, and negative predictive value were calculated, and the optimal cut-off point was evaluated. Multiple logistic regression analysis was performed to control the effects of potential confounding factors. When the subjects with 3 or more CCs and an EOI score of 3 or higher were regarded as a high-EE group, and the others as a low-EE group, the risk of relapse during the 9 months was 83.3% (5/6) and 19.2% (5/26), respectively, and the relapse risk ratio (95% confidence interval) was 4.3 (1.8 - 12.2). The values of the validity parameters were the highest with these cut-off points. The effect of EE was significant also on multiple logistic regression analysis. EE based on CFI correlated with relapse also in Japan. Less