Background

: Community based family interventions and relative's expressed emotion (EE) have shown to influence the course of schizophrenic disorders. We studied the relation between family intervention, EE and relapse during a twelve months outpatient treatment period which followed a three months family oriented inpatient programs.

Methods: After inpatient treatment and assessment of EE 76 patients were stratified and randomly assigned to differential treatment groups: one standard and one standard plus family treatment (ST+FT) (ST). Relapses and/or exacerbations were conservatively measured and based on Brief Psychiatric Rating Scale (BPRS) and clinical psychiatric driteria.

Results: Overall relapse rates (12/76) of the treatment programs were low (16%). An effect due to addition of FT+ST could not be demonstrated Contrary to expectation, patients in low EE-families relapsed more in the FT+ST treatment group.

Conclusions: An intensive family oriented inpatient treatment, followed by standard outpatient treatment, has a favourable impact on relapse. Family therapy added to standard treatment did not affect the relapse rate. Family intervention in low EE-families may induce stress, thus influencing relapse.