Expressed emotion among families and course of schizophrenia in Japan: A 2-year cohort study

A 2-year cohort study was conducted to determine whether expressed emotion (EE) in families is associated with relapse of schizophrenia in Japan. Key relatives of 52 schizophrenic patients were interviewed using the Camberwell Family Interview (CFI) and the patients were classified into high and low EE groups. The 2-year relapse risks were 71% (17/24) in the high EE group and 37% (10/27) in the low EE group. The risk ratio was 1.9 and the 95% confidence interval (CI) ranged from 1.1 to 3.3. In the multiple logistic regression analysis, the odds ratio between families' EE and schizophrenic relapse was 4.6, controlling for other potential confounding factors. It was concluded that, in Japan, the families' EE is a good predictor for schizophrenic relapse within 2 years. This association between EE and relapse could be due to the strong difference in the first 9 months. The period during which EE's predictive validity for schizophrenic relapse is applicable may vary according to the society to which the patients and their families belong.