Pattern of emotional overinvolvement in relatives of patients with schizophrenia: A stress syndrome analogue?

The aetiology of relatives' criticism (CC), hostility (H), and emotional overinvolvement (EOI) towards patients with schizophrenia is not clear. We analysed data from a study about expressed emotion (EE) in relatives of patients with schizophrenia according to DSM-III-R, to explore evidence of a relationship between EE pattern and a stress response syndrome in the relatives. CC, H, and EOI in 58 relatives of 40 patients with schizophrenia were assessed with the Camberwell Family Interview (CFI) shortly after admission and 4.5 months after discharge. Each relative's stress response was assessed with the General Health Questionnaire (GHQ-30). Relatives with a consistently high or a shifting EOI level reported prolonged higher stress scores than relatives with consistently low EOI level. We found no association between CC, H, and prolonged higher stress scores. Our study suggests that EOI could be linked to a stress response syndrome, whereas this does not seem to be the case for CC and H. If confirmed in future studies, this finding indicates that different treatment approaches should be offered to families of psychotic patients depending on the pattern of CC and EOI.