EXPRESSED EMOTION AND SHORT-TERM TREATMENT OUTCOME OF OUTPATIENTS WITH MAJOR DEPRESSION

Expressed emotion (EE) is the attitude of criticism and emotional over involvement of a key relative toward a patient, and is one of the fami ly factors that contribute to the course of psychiatric illness. The r elationship between EE and 6-month outcome in 40 outpatients with majo r depression was investigated in this study. In the nonremission group (n = 17, 43.7%), there was a higher prevalence of past history of dep ression (P < .01) and high-EE relatives (P < .05) than in the remissio n group (n = 23). On an EE profile based on a Five-Minute Speech Sampl e (FMSS), 15.0% (n = 6) of the cases were high-EE: three were rated as emotional overinvolvement (EOI), two as critical, and one as EOI and critical. On the critical subscale, the rate of nonremission increased gradually in response to the level of criticism (from pure low-EE, to borderline-Critical [b-critical], and then to high-critical). Multipl e logistic regression analysis showed that the level of criticism and a past history of depression were significant predictors of poor outco me (P < .05). These results indicate that criticism from family member s may be one factor that prolongs depressive episodes. Copyright (C) 1 996 by W.B. Saunders Company