[Expressed emotion and six-month treatment of outcome of depressive outpatients with mood disorder].

The relationship of the Expressed Emotion (EE) and the outcome of 45 major depressive outpatients with DSM-II-R Mood Disorder was investigated for 6 month prospectively. In the non-remission group (n = 19, 42.2%), past history of major depressive episode was significantly high (p < .01), and there were more high-EE relatives (p < .05) than in the remission group (n = 26). Including borderline-EE (b-EE) as high-EE, the patients in the non-remission group were also more likely to live with high-EE relatives (p < .01) than those in the remission group. On the EE profile rated by the Five Minute Speech Sample, high-EE was 13.3% (n = 6). In the high-EE relatives, 3 were rated as emotional over-involvement (EOI), 2 were Critical, and 1 was EOI and Critical. All of b-EE, (15.6%; n = 7) were rated as the b-Critical. On the Critical subscale, the rate of non-remission increased gradually in the response of the level of criticism (from pure low-EE, b-Critical, and to Critical). With the Hayashi's second method of quantification, the level of criticism and past history of depression correlated with six month outcome. These results might indicate the problem of vicious circle around the recurence, criticism of families, and relapse or prolongation of the episode in depression. It was also suggested that a careful psychoeducational family approach focusing to reduce the negative escalation for patients and their families would contribute to the treatment for mood disorder.