The impact of caregivers' expressed emotion and the patients' perception of expressed emotion on the positive and negative symptoms of patients with schizophrenia in a sample from Turkey

Amaç: Şizofreni tanısı alan hastaların hastalıklarının nüks etmesi üzerinde bakım verenlerin duygu dışavurumunun etkisini araştıran çok sayıda araştırma bulunmakla birlikte, hastaların tarafından algılanan duygu dışavurumun hastalık sonucu üzerinde nasıl bir etkisi olduğu konusunda araştırmalar azdır. Bu çalışmanın ana amacı şizofreni tanısı olan hastaların belirti düzeyi üzerinde bakım verenlerin duygu dışavurumu ve hastalar tarafından algılanan duygu dışavurumunun etkisini incelemektir. Yöntem: Yapılan uzunlamasına çalışmanın ilk değerlendirme oturumunda 116 stabil durumda olan hastaya Algılanan Duygu Dışavurumu Ölçeği (ADDÖ), temel sonuç ölçümü olarak Şizofreni için Pozitif ve Negatif Belirti Ölçeği (PANSS) uygulanmıştır. Bakım verenlere ise Duygu Dışavurumu Ölçeği (DDÖ) verilmiştir. Altı ay sonraki ikinci değerlendirme oturumunda, hastalara PANSS yeniden uygulanmıştır.Bulgular: Hastaların algıladıkları duygu dışavurumu bakım verenlerin duygu dışa vurumuna göre belirti düzeyi üzerinde daha önemli bir unsur olmuştur. Hastaların bakım verenlerinden algıladıkları eleştirel oluş / düşmanlık PANSS ile elde edilen pozitif ve negative belirtiler ve toplam puanlar üzerinde riskli unsur olarak bulunmuştur. Hastaların algıladıkları bakım verenlerin aşırı koruyucu kollayıcı oluşları eleştirel oluş / düşmanlığa göre depreşmeye karşı daha koruyucu bir unsur olarak görünmektedir.Sonuç: Aşırı koruyucu kollayıcı olan aile ortamı şizofreni tanısı olan hastaların depreşmelerine karşı koruyucu bir faktör olabilir. Bu bulgu kültürel bağlam içinde değerlendirilmelidir. Psikososyal müdahalelerin sosyokültürel farklılıklara göre düzenlenmesi ve yürütülmesi gerekir. Çalışmanın klinik doğurguları ve sınırlılıkları ile ileriki çalışmalar için öneriler sunulmuştur.

Türkiyeden bir örneklemde şizofreni tanısı alan hastaların pozitif ve negatif belirtileri üzerinde bakımverenlerin duygu dışavurumu ve hastaların algıladığı duygu dışavurumunun etkisi

Objective: Although the effects of caregivers expressed emotion on the relapse of patients with schizophrenia have been studied widely, there is a relative paucity of research on how the patients perceived expressed emotion affects outcome in schizophrenia. The main aim of this study was to examine the relative impacts of patients perceived expressed emotion and the caregivers expressed emotion on the symptom severity of patients with schizophrenia. Method: In this prospective study, at the first assessment session, 116 stable patients were administered the Perceived Expressed Emotion Scale (PEES), the Positive and Negative Symptom Scale for Schizophrenia (PANSS) as the primary outcome measure. Their caregivers were administered the Expressed Emotion Scale (EES). At the second assessment six months later, PANNS was re-administered to the patients. Results: The patients perceived expressed emotion was more important than caregivers expressed emotion on symptom severity. It was found that patients perceived criticism/hostility (C/H) was a risky element on positive and negative symptoms, and on the total scores of PANSS. Patients perceptions of emotional over-involvement (EOI) appeared to be stronger protectors against relapse than C/H.Conclusion: Family environments with high EOI may protect against relapse in patients with schizophrenia. This finding can be interpreted in cross-cultural context. Psychosocial interventions should foster and maintain according to the cultural differences. The limitations and clinical implications of the results and directions for future studies were suggested.

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