Influence of carer expressed emotion and affect on relapse in non-affective psychosis

This study aimed to investigate the relationships between carer expressed emotion, patients’ symptoms and carer characteristics during a recent relapse of psychosis. A total of 86 patients and carers were investigated in a cross-sectional design. Patients whose carers showed high expressed emotion had significantly higher levels of anxiety and depression, but not more psychotic symptoms or lower self-esteem. Linear regression showed that carers’ critical comments predicted anxiety in patients. Critical comments were related to low carer self-esteem and avoidant coping strategies. Low carer self-esteem was also related to carer depression, stress and carer ‘burden’, and to low patient self-esteem. The authors concluded that carer criticism was associated with patient anxiety, low carer self-esteem and poor carer coping strategies. Family interventions should focus on improving these after a relapse of symptoms of psychosis.