The association between parental expressed emotion and psychotic relapse: applying a quantitative measure for expressed emotion

In an earlier study, a quantitative measure for expressed emotion (EE) was constructed. This comprised six items of the Five-Minute Speech Sample, which formed a criticisms/dissatisfaction scale and a second scale, concerning emotional overinvolvement, which consisted of two items. In the present study, the association between psychotic relapse and the quantitative scales for EE and the original dichotomous index was investigated. A strong association with psychotic relapse was found among mothers using the criticisms/dissatisfaction scale. No interaction between the EE scores of fathers and mothers was found. Therefore, the mean score of two interviewed parents was taken as the family profile score. With this family measure, a stronger effect was found than when the parents were analysed separately. The quantitative measure for emotional overinvolvement was not associated with psychotic relapse. With the original dichotomous index, no significant effects were found, except for a trend in the subgroup of mothers. The results support the hypothesis that a quantitative measure for EE is a better predictor of psychotic relapse than a dichotomous index.