Expressed emotion, family environment, family intervention and the psychiatric relapse of patients with severe mental disorders in Iran

Abstract

The purpose of this study was to explore the effect of short-term family psychoeducation on reducing expressed emotion and improving the family environment in families of patients with severe mental disorders and relapse of the patient. Using an experimental design, pre-test, post-test and a control group, the families of 30 patients with severe mental disorders were divided into two groups. The groups consisted of an intervention group (six sessions of family psychoeducation) and a control group. Expressed emotion was assessed using the Family Questionnaire and family environment was assessed by the Family Environment Scale. Relapse was measured by the re-admission and a significant increase in medication dosage. Results showed that the family psychoeducation program had not changed the emotional over-involvement score but it had had a significant influence on the reduction of the critical comments score. It had improved cohesion and expressiveness in family members but it had had no significant influence on the conflict score. The relapse rate was not statistically significant between the two groups, but the intervention group showed lower levels of relapse rate compared to the control group. The present study confirmed the need for resources to offer longer-term culturally-appropriate family psychoeducation to the families of patients in Iran.

Keywords:

• expressed emotion
• family environment
• family intervention
• severe mental disorders

Acknowledgements

Preparation of this research was supported in part by a grant from the Excellency Center of Family Research Institute of Shahid Beheshit University. We would like to thank the families of patients who participated in the family psychoeducation sessions, hence helping to improve the quality of the culturally-appropriate family psychoeducation program.