Mood disorders and expressed emotion (EE) of families

对日本心境障碍患者的家庭进行Camberwell家庭访谈（CFI）中情绪表达（EE）评分的可靠性和情绪表达特征的评估。研究对象是27名情绪障碍患者及其31名家属。对情感表达评分有重要影响的批评评论（CC）、敌意(H)和情绪过度投入（EOI）， Spearman相关系数和kappa值为0.4 ~ 0.8，情绪障碍的情感表达评分信度不高。在H和EOI中，阳性同意的比例特别低。日本情绪障碍患者的家庭中CCs的发生率低于精神分裂症患者或美国或欧洲情绪障碍患者的家庭。需要重新评估情感表达在情绪障碍中的可信度。情绪障碍患者的家庭比精神分裂症患者的家庭更压抑表达的情绪。根据DSM-IV和ICD-10诊断为情绪障碍的患者和36名主要家庭成员。患者入院后2周内，CFI对患者家属进行访谈，并进行EE评估。在患者出院后随访9个月，进行队列研究。采用cc数和EOI数的几个截断点将患者分为高情感表达组和低情感表达组，比较9个月内的复发风险，计算复发风险比及其95%置信区间。计算敏感性、特异性、阳性预测值和阴性预测值，并评估最佳分界点。采用多元logistic回归分析控制潜在混杂因素的影响。将3例及以上cc患者和3分及以上的EOI分为高情感表达组，其余为低情感表达组，9个月内的复发风险分别为83.3%（5/6）和19.2%(5/26)，复发风险比（95%置信区间）为4.3（1.8 ~ 12.2）。这些分界点的效度参数值最高。多元logistic回归分析显示，情感表达的影响也显著。在日本，基于CFI的EE也与复发相关。少

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