Marom Sofi, Munitz Hanan, Jones Peter B, Weizman Abraham, Hermesh Haggai
Anxiety Disorders Unit, Geha Mental Health Center, Petach-Tikva, Israel.
Schizophr Bull. 2002;28(4):731-43. doi: 10.1093/oxfordjournals.schbul.a006976.
We investigated the validity of expressed emotion (EE) in Israel. The study sample consisted of 108 patients with schizophrenia and 15 with schizoaffective disorder, and their key relatives. EE was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism and emotional overinvolvement. Patients were rated with the Brief Psychiatric Rating Scale (BPRS) at admission, at discharge, and 6 months after discharge. Readmissions were determined over a 9-month period. High EE and particularly high criticism were significantly associated with poorer outcome (higher rate of and earlier readmissions, and higher BPRS score at followup) and worse illness course (higher annual number of prior psychiatric hospital admissions). Odds ratios between high EE and high criticism and readmission were 2.6 and 3.5, respectively. The strongest predictor of earlier readmission was the interaction of high criticism x poor compliance with medication. The results converge to further confirm the notion that familial EE is a valid crosscultural predictor of the clinical course of schizophrenia. Moreover, EE has predictive power in very chronic samples. Criticism appears to be the crucial EE component linked with short-term outcome. Treatment aimed at reducing high criticism is warranted. The FMSS appears to have predictive validity.
我们在以色列对情感表达（EE）的有效性进行了调查。研究样本包括108名精神分裂症患者、15名分裂情感性障碍患者及其主要亲属。使用五分钟言语样本（FMSS）对情感表达进行评分。患者家庭根据情感表达及其两个组成部分进行分类：批评和情感过度卷入。在入院时、出院时以及出院后6个月，使用简明精神病评定量表（BPRS）对患者进行评分。在9个月的时间内确定再入院情况。高情感表达，尤其是高批评与较差的预后（再入院率更高、再入院更早以及随访时BPRS评分更高）和更差的病程（既往精神科住院次数更多）显著相关。高情感表达和高批评与再入院之间的比值比分别为2.6和3.5。再入院较早的最强预测因素是高批评与药物依从性差的相互作用。这些结果进一步证实了家庭情感表达是精神分裂症临床病程的有效跨文化预测因素这一观点。此外，情感表达在非常慢性的样本中具有预测能力。批评似乎是与短期预后相关的关键情感表达组成部分。有必要采取旨在减少高批评的治疗措施。FMSS似乎具有预测效度。
