Impact of expressed emotion on schizophrenic patients among primary caregivers in a national psychiatric hospital in Asmara, Eritrea

Introduction: Schizophrenia is a mental disorder characterized by a breakdown in thinking, poor emotional responses, it burdens afflicted individuals, their families, and society. Expressed emotion refers to verbalization of strong feelings by patients of schizophrenia which often causes relapse. Objective: The main objective of this study was to assess the socio-demography of the primary care givers, the impact of emotional expression, and the association of emotional expression of primary care givers in relation to relapse rate on schizophrenic patients in a National Psychiatric Hospital. Methods: A Quantitative Descriptive Cross-Sectional Study was carried out to assess the level of expressed emotion of primary care givers towards schizophrenic patients at National Psychiatric Hospital in Asmara, from 17 November to 8 December 2016. Through face to face interview using structured (LEE-S) questionnaire. Result and discussion: The study included three hundred twenty-three participants who are adult primary care givers of the schizophrenic patients in National Psychiatric Hospital. Majority of the respondents 68 (55.28%) were males and 91(73.98%) of them were married. The study findings showed a positive correlation ( r= 0.288) and significant level of association ( p value =0.001) between expressed emotion level and relapse rate, indicating that high expressed emotion which means that most aggressive patients can experience relapse frequently compared to less aggressive patients who present with low expressed emotion. A significant association between the gender of primary care givers and expressed emotion (p- value = 0.006) was identified. Further to this, the study findings indicated that age, marital status, residence and educational level of primary care givers had no significant association with expressed emotion. A significant association between drug compliance and relapse rate of high expressed emotion was observed (p-value =0.026) indicating that higher relapse rate in those who had high expressed emotion. A significant association (p-value = 0.013) was found between attitude towards illness and relapse rate; whereas there was no any association between intrusiveness, hostility and tolerance, and relapse rate. Conclusion: This study concluded that high expressed emotion of primary care givers was found to have a positive significant association with relapse rate including the gender of primary care givers as well. The study further pinned down that, age, marital status, residence and educational level of primary care givers had no association with expressed emotion however still, there was a significant association between drug compliance and relapse rate of high expressed emotion. The following factors had an influence on this study, country climate, tradition, culture of the community caregivers as well as involvement of traditional remedies and practices towards schizophrenia.