Expressed emotion: Relevance to rehospitalization in schizophrenia over 7 years

Sofi Marom, Hanan Munitz, Peter B. Jones, Abraham Weizman, Haggai Hermesh

Research output: Contribution to journalArticlepeer-review


Expressed emotion (EE) is an established factor in short-term relapse in schizophrenia. However, data on its long-term predictive ability are scarce. We extended our short-term investigation over 7 years' followup. The study population consisted of 108 patients, 93 with schizophrenia and 15 with schizoaffective disorder. EE of the key relatives was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism (CR) and emotional overinvolvement (EOI). High CR was associated with earlier first and second readmissions (Breslow p = 0.002 and 0.04, respectively). High CR was associated with a higher rate of readmissions (p = 0.01) and a longer hospital stay (p = 0.02) compared with low CR. Both compliance with pharmacotherapy and the interaction of high-CR x poor compliance were additional contributors to time to first readmission. This study is the first to demonstrate the prolonged predictive validity of EE. Our results support the value of CR as a prognostic indicator of the course of schizophrenia. The FMSS appears to have predictive power in respect to psychiatric hospitalization. Therapies aimed at lowering high EE seem warranted as a long-term preventive approach.

Original languageEnglish
Pages (from-to)751-758
Number of pages8
JournalSchizophrenia Bulletin
Issue number3
StatePublished - Jul 2005


  • Expressed emotion (EE)
  • Family relatives
  • Hospitalizations
  • Long-term course


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