A review of expressed emotion research in health care

Much research has been carried out on the impact of family, relationships o n the development and course of different illnesses. Research on Expressed Emotion (EE) developed out of studies of the impact of family members on pa tients with schizophrenia, and has provided us with a robust measure of rel atives' emotional attitudes towards patients, which has now been applied in the study Of numerous psychiatric and medical illnesses. This review outli nes the history of EE research in schizophrenia, and discusses the evidence for the association between family EE and the course of schizophrenic illn ess. Some of the factors which might moderate the association between EE an d illness course are outlined and the issues of the meaning and development of EE are dismissed in the light of recent theoretical advances. The appli cation of the EE methodology in other psychiatric and medical conditions is then reviewed and conclusions are drawn about the extent to which EE predi cts illness course in conditions other than schizophrenia. Consideration is given to the ways in which the application of the paradigm to a variety of illnesses or conditions with different features can enhance our understand ing of the EE construct. (C) 2000 Elsevier Science Ltd.