Evaluating the role of active and passive psychoeducation in modulating expressed emotion among caregivers of schizophrenia

Background: Expressed emotion (EE) is a key psychosocial factor influencing relapse and functional outcomes in schizophrenia. Psychoeducation helps reduce EE and improve caregiver coping, but comparative data on active vs. passive formats—especially in low-resource settings—remain limited. Aim: To compare the impact of active versus passive psychoeducation on caregivers’ EE over one month and identify socio-demographic and clinical factors associated with EE. Materials and Methods: A quasi-experimental study was conducted with 60 primary caregivers of individuals with schizophrenia at a psychiatric outpatient clinic. Group 1 ( n = 30) received active psychoeducation through interactive sessions; Group 2 ( n = 30) received passive psychoeducation via printed materials and brief instructions. Socio-demographic, clinical data, and family attitude scale (FAS) scores were collected at baseline and 1-month follow-up. Analyses included t-tests, Chi-square tests, and multivariate linear regression. Results: Caregivers had a mean age of 37.65 ± 4.1 years, with females and spouses (51.66%) forming the majority. Both groups showed significant reductions in FAS scores at follow-up ( P < 0.001), with greater improvement in the active group. However, psychoeducation type was not an independent predictor of FAS scores. Conclusion: Both psychoeducation formats effectively reduce EE, with active formats showing greater short-term benefits. Socio-demographic factors significantly influence EE, underscoring the need for tailored interventions.