The measurement of expressed emotion in the families of psychiatric patients.

In a series of studies of the influence of family life on the course of an established schizophrenic illness, it has been shown that the level of emotion expressed by relatives shortly after a schizophrenic patient is admitted to hospital is strongly associated with symptomatic relapse during the nine months following discharge (Brown et al., 1962, 1972). This paper states the case for an abbreviated version of the primary research instrument used in these studies, the Camberwell Family Interview Schedule. In the 1972 study the single most important measure contributing to the overall expressed emotion index proved to be the number of critical remarks made about the patient by the relative when interviewed alone. An analysis of 15 tape-recorded interviews from this study showed that the majority of critical comments were produced within the first hour and there was virtually no relationship between total number of critical comments and length of interview (r = 0.08). This analysis supported the use of a shortened interview in which the areas most likely to produce any criticism were given priority in the sequence of questioning. This abbreviated version has been used successfully in a replication and extension of the 1972 study. A group of 37 schizophrenic patients is being compared with a group of 31 depressed neurotic patients. Patterns of emotional response of these patients' relatives are discussed.