Expressed emotion (EE) is a measure of the family environment that is based on how the
relatives of a psychiatric patient spontaneously talk about the patient. Currently,
interventions based on reducing high EE are considered integral to the
psychosocial component of treatments for schizophrenia. And patients’
perspective on relatives’ attitude and behavior towards them (expressed emotions)
may be an important addition to the current focus on relatives’ perspective
only, as measured by Camberwell Family Interview (CFI) or other methods. Based
on the theory of EE, the authors designed a brief, three-item questionnaire
completed by patients, named Felt Expressed Emotion Rating Scale (FEERS) and aimed to
investigate the test-retest reliability of the FEERS and associations between
the FEERS and the CFI and to which extent FEERS scores were modified by
severity of psychotic symptoms, cognitive function, patient mood and amount of
face-to-face contact with relatives.
In this study, forty-five patients (18 - 39 years old) with
schizophrenia and related psychoses admitted to a psychiatric hospital and 67
relatives were included. Assessments included FEERS, CFI and Positive and
Negative Syndrome Scale (PANSS). The results indicated that FEERS-Cri
test-retest intra-class correlation (ICC1,1) was 0.71 among patients
with low total PANSS scores, low cognitive impairment (0.59) and depression
(0.63). For low levels of cognitive impairment, the ICCs of the FEERS-Wo and
the FEERS-Con were 0.62 and 0.83, respectively. The FEERS-Cri and FEERSHowWo
correlated significantly with CFI-CC and CFI-positive comments, respectively.
Among the relatives that the patient deemed “not at all critical” (low
FEERS-Cri scores), 94% had low CFI-CC levels.
In conclusion,
the FEERS may be an efficient screening instrument for identifying how patients
perceive relatives attitude and behavior, especially in patients with less
severe psychosis, less depression and less impaired cognitive function. FEERS
may also be a brief and valid instrument to rule out high levels of EE in
families. Those capacities may have important treatment implications.
Article
by Heidi Bjørge, et al, from Norway.
Full
access: http://mrw.so/17VDia
Image
by Thorsten Vogt, from Flickr-cc.
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