Uehara T, Kawashima Y, Goto M, Tasaki S I, Someya T
Department of Neuropsychiatry, University of Gunma Faculty of Medicine, 3-39-22 Showa-cho, Maebashi, Gunma 371-8511, Japan.
Compr Psychiatry. 2001 Mar-Apr;42(2):132-8. doi: 10.1053/comp.2001.21215.
Psychosocial variables such as expressed emotion (EE) have prognostic significance, and family psychoeducation has been developed to aid in the treatment of various psychiatric disorders. This study reports relationships among EE, family factors, and symptoms observed while conducting multifamily psychoeducation for eating disorders. Group sessions were held once a month for the relatives of patients with DSM-IV eating disorders, and the group met for five sessions that included both education and problem-solving. Thirty-seven relatives volunteered to participate in our program, and of these, 28 completed the program. EE (as measured by the Five-Minute Speech Sample [FMSS]), family function (as measured by the Family Adaptability and Cohesion Evaluation Scales [FACES]), the family's mental state (as measured by the Profile of Mood States [POMS]), and patient's symptoms (as measured by the Eating Disorder Evaluation Scales [EDES] and Global Assessment of Functioning [GAF] on clinician evaluations, and by the Anorexic Behavior Observation Scale [ABOS] assessment of the family) were administered at both the first and final sessions. The rates of high-EE relatives tended to decrease (especially high emotional overinvolvement [EOI]), and families' assessment of symptoms was also significantly improved. Twice-repeated multivariate analysis of variance (MANCOVA) showed that EOI, ABOS, and POMS scores were changed significantly during the sessions. Psychoeducation for the family members of patients with eating disorders might help lower distress and encourage positive interactions within the family. EE is an important measure in evaluations of psychoeducation. However, a randomized, controlled trial is needed to clarify the efficacy of this treatment.
诸如情感表达（EE）等社会心理变量具有预后意义，家庭心理教育已被开发用于辅助治疗各种精神疾病。本研究报告了在为饮食失调症开展多家庭心理教育期间观察到的EE、家庭因素和症状之间的关系。为患有DSM-IV饮食失调症患者的亲属每月举办一次小组会议，该小组共进行五次会议，包括教育和解决问题环节。37名亲属自愿参加我们的项目，其中28人完成了该项目。在第一次和最后一次会议上均进行了情感表达（通过五分钟言语样本[FMSS]测量）、家庭功能（通过家庭适应性和凝聚力评估量表[FACES]测量）、家庭心理状态（通过情绪状态剖面图[POMS]测量）以及患者症状（通过饮食失调评估量表[EDES]和临床医生评估的功能总体评定量表[GAF]，以及通过家庭的神经性厌食行为观察量表[ABOS]评估）的测量。高情感表达亲属的比例趋于下降（尤其是高情感过度卷入[EOI]），家庭对症状的评估也有显著改善。两次重复多变量方差分析（MANCOVA）表明，在会议期间EOI、ABOS和POMS得分有显著变化。为饮食失调症患者的家庭成员开展心理教育可能有助于减轻痛苦并促进家庭内部的积极互动。情感表达是心理教育评估中的一项重要指标。然而，需要进行一项随机对照试验来阐明这种治疗方法的疗效。
