The Influence of Family and Social Factors on the Course of Psychiatric Illness

TLDR

Prior research has shown that the emotional expression of a key relative predicts relapse in schizophrenia, making family life a key factor in illness course. This study replicated that finding in both schizophrenia and depressive neurosis patients, found that expressed emotion predicts relapse independently of other factors, and identified additive effects with treatments that allow precise relapse prediction, with differing patterns between the two groups.

Abstract

Summary This study is a replication and extension of past work carried out by Brown, Birley and Wing (1972) concerning the influence of family life on the course of schizophrenia. In the original research the index of emotion expressed by a key relative about the patient at the time of key admission proved to be the best single predictor of symptomatic relapse in the nine months after discharge from hospital. In the present study this main finding of Brown et al has been replicated for two clinically different groups of psychiatric patients. The expressed emotion of the relative again seems to be associated with relapse independently of all other social and clinical factors investigated. In addition, important additive effects between various social influences and pharmacological treatments have been revealed which make it possible to predict relapse patterns in schizophrenia with considerable precision. The patterns of these relationships with relapse are different for the two clinical groups studied, patients with schizophrenic psychosis and with depressive neurosis.