Abstract
A robust association has been established between the level of expressed emotion (EE) shown by relatives and the outcome of schizophrenia in patients living with them (Brown, Monck, Carstairs, and Wing, 1962; Brown, Birley, and Wing, 1972; Vaughn and Leff, 1976a; Leff and Vaughn, 1981). Relapse of schizophrenia is more likely if patients live with relatives who are excessively critical and/or overinvolved. Such relatives are designated as high EE. Two factors appeared to operate in a protective manner for patients living whith high EE relatives. These were regular maintenance therapy with neuroleptic drugs and the establishment of a social distance between patient and relative, as measured by the amount of face-to-face contact during a typical week. Furthermore, these two factors seemed to be additive in their protective effect. The evidence for these conclusions was derived from an analysis of pooled data from the two most recent studies (Brown et al., 1972; Vaughn and Leff, 1976a). The relevant figure setting out these results is reproduced here (Figure 1).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Berkowitz, R., Kuipers, L., Eberlein-Fries, R., and Leff, J. (1981). Lowering expressed emotion in relatives of schizophrenics. In M. J. Goldstein (Ed.). New Developments in Interventions with Families of Schizophrenics. London: Jossey-Bass.
Brown, G. W., and Birley, J. L. T. (1968). Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behaviour, 9, 203–214.
Brown, G. W., Birley, J. L. T., and Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–258.
Brown, G. W., Monck, E. M., Carstairs, G. M., and Wing, J. K. (1962). Influence of family life on the course of schizophrenic illness. British Journal of Preventive and Social Medicine, 16, 55–68.
Créer, C., and Wing, J. (1975). Living with a schizophrenic patient. British Journal of Hospital Medicine, 14, 73–82.
Goldstein, M. J., Rodnick, E. H., Evans, J. R., May, P. R. A., and Steinberg, M. R. (1978). Drug and family therapy in the aftercare of acute schizophrenics. Archives of General Psychiatry, 35, 1169–1177.
Hirsch, S. R., and Leff, J. P. (1975). Abnormalities in parents of schizophrenics (Maudsley Monograph No 22.). London: Oxford University Press.
Hogarty, G. E., and Goldberg, S. C. (1973). Drug and sociotherapy in the aftercare of schizophrenic patients. One-year relapse rates. Archives of General Psychiatry, 28, 54–64.
Hogarty, G. E., Goldberg, S. C., Schooler, N. R., and Ulrich, R. F. (1974). Drug and sociotherapy in the aftercare of schizophrenic patients. II. Two-year relapse rates. Archives of General Psychiatry, 31, 603–608.
Hogarty, G. E., Schooler, N. R., Ulrich, R. F., Mussare, F., Ferro, P., and Herron, E. (1979). Fluphenazine and social therapy in the aftercare of schizophrenic patients. Archives of General Psychiatry, 36, 1283–1294.
Leff, J. P. (1976). Schizophrenia and sensitivity to the family environment. Schizophrenia Bulletin, 2, 566–574.
Leff, J. P. (1981). Clinical and methodological problems in interaction studies. In G. Tognoni, C. Bellantuono, and M. Lader (Eds.), Epidemiological Impact of Psychotropic Drugs. Amsterdam: Elsevier.
Leff, J. P., Kuipers, L., Berkowitz, R., and Sturgeon, D. (in press). A controlled trial of social intervention in the families of schizohrenic patients: Two year follow-up. British Journal of Psychiatry.
Leff, J. P., and Vaughn, C. (1981). The role of maintenance therapy and relatives’ expressed emotion in relapse of schizophrenia: a two-year follow-up. British Journal of Psychiatry, 139, 102–104.
Leff, J. P., and Wing, J. K. (1971). Trial of maintenance therapy in schizophrenia. British Medical Journal, 3, 599–604.
Orford, J., and Edwards, G. (1977). Alcoholism (Maudsley Monograph No 26). London: Oxford University Press.
Priestley, D. (1979). Schizophrenia and the family: II. In J. K. Wing and R. Olsen (Eds.), Community Care for the Mentally Disabled. London: Oxford University Press.
Sturgeon, D., Kuipers, L., Berkowitz, R., Tur-pin, G., and Leff, J. (1981). Psychophysiological responses of schizophrenic patients to high and low expressed emotion relatives. British Journal of Psychiatry, 138, 40–45.
Tarrier, N., Vaughn, C. E., Lader, M. H., and Leff, J. P. (1979). Bodily reactions to people and events in schizophrenia. Archives of General Psychiatry, 36, 311–315.
Vaughn, C. E., and Leff, J. P. (1976a). The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125–127.
Vaughn, C. E. and Leff, J. P. (1976b). The measurement of expressed emotion in families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165.
Wing, J. K., Cooper, J. E., and Sartorius, N. (1974). Measurement and classification of psychiatric symptoms. Cambridge: Cambridge University Press.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1986 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Leff, J., Kuipers, L., Berkowitz, R., Eberlein-Vries, R., Sturgeon, D. (1986). Controlled Trial of Social Intervention in the Families of Schizophrenic Patients. In: Goldstein, M.J., Hand, I., Hahlweg, K. (eds) Treatment of Schizophrenia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-95496-2_14
Download citation
DOI: https://doi.org/10.1007/978-3-642-95496-2_14
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-16628-3
Online ISBN: 978-3-642-95496-2
eBook Packages: Springer Book Archive