The low prevalence of high levels of expressed emotion in Bali

The present study contrasts the expressed emotion (EE) status in family mem bers of schizophrenic patients between Bali (Indonesia) and Tokyo (Japan), the former being a non-industrialized society and the latter an industriali zed society in Asia. The EE ratings of each key relative for 62 consecutive ly hospitalized schizophrenic patients at the Bangli State Mental Hospital (Bali) and 33 consecutively admitted schizophrenics at Komagino Hospital (T okyo) were obtained using the Five Minute Speech Sample (FMSS) method. A si gnificantly lower prevalence of high EE (12.9%) was observed in Bali compar ed with Tokyo (36.4%) (P < 0.01). This result may explain the better social adjustment of schizophrenics in Bali. In addition, in Bali, to clarify the EE effect in this non-industrialized society, we examined the relationship between each key relative's EE and the patient's psychotic symptoms at adm ission, as assessed by the Brief Psychiatric Rating Scale (BPRS) and the Sc ales for the Assessment of Negative Symptoms (SANS). Moreover, the associat ion between each family member's EE and a patient's rate of re-admission ov er the 1-year period following discharge was evaluated. The EE value was si gnificantly related to the anxious-depression factor score in the BPRS, but not to either of the other factor scores in the BPRS or SANS subscales. Fu rthermore, EE status was not a reliable predictor of patient re-admission o ver the 1-year period following discharge in Bali. (C) 2000 Elsevier Scienc e Ireland Ltd. All rights reserved.