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Tijdschrift voor Psychiatrie 36 (1994) 7

New research

`Expressed Emotion (EE)' and patient attributes as risk factors for psychotic relapse in schizophrenic disorders

D.H. Linszen, P.M.A.J. Dingemans, W.F. Scholte, M.E. Lenior, A.J.W. van der Does, M.A. Nugter

In the context of a prospective, controlled treatment study, contrasting family intervention with individual treatment, the role of Expressed Emotion as a predictor of relapse was examined in patients with recent onset schizophrenic disorders (n = 97). Expressed Emotion was compared with 12 predictor variables. The variables were taken from EE and family intervention studies and related to demography, premorbid functioning, present and past illness history and co-morbid substance abuse. Psychotic relapse was operationalized with a conservatively measured relapse criterion, composed of ratings based on the Brief Psychiatric Rating Scale and on clinical psychiatric judgment. Of the thirteen predictor variables entered in stepwise regression analyses, six variables had a probable predictive power on the conservative relapse criterion and its components. These variables were entered in a Cox regressionmodel. EE turned out to be the strongest significant predictor of relapse in the overall sample (OR 4.90;c.i. 1.05-22.92). This finding remained, when only patients with a first psychotic episode (p = 0.01) and patients in the individual treatment condition (p = 0.001) were examined.