EXPRESSED EMOTION AND DEPRESSION - A LONGITUDINAL-STUDY

Background Previous studies show that criticism by relatives during ac ute depressive illness predicts relapse over nine months, but the cour se of criticism over time and its relation to the course of illness, h ave not been examined in depressed patients. Method Thirty-nine depres sed patients and their partners, were interviewed separately at three- monthly intervals over about one year. illness was assessed by Researc h Diagnostic Criteria and Hamilton Depression Rating Scale. Criticism was measured by the Camberwell Family Interview. Results Criticism whe n patients were most depressed predicted neither remission nor subsequ ent relapse. Patients who fully recovered, with or without later relap se, had partners who were consistently uncritical, or critical only at presentation. Patients with residual symptoms during remission had mo re persistently critical partners. Conclusions The nature of the assoc iation between criticism and depression could not be unequivocally est ablished, although it appeared likely that continuing criticism was a result of continuing depression. Relatives' understanding of the illne ss may mediate between levels of criticism and the course of depressio n.