Abstract: Schizophrenia is a severe mental illness that leads to numerous psychosocial issues for patients and caregivers. A disturbed family atmosphere often results in a high expressed emotion (EE), which is linked to relapse in many patients. This review explores the impact of EE on schizophrenia relapse rates and the influence of cultural beliefs on caregivers’ attitudes. A comprehensive literature search was performed across online databases such as PubMed, PsycINFO, and the Cochrane Library, as well as unpublished literature from various universities. Seventeen full papers were selected based on predefined inclusion criteria, focusing on the relationship between aspects of EE and schizophrenia relapse. About five decades of research highlight that high EE from caregivers strongly predicts relapse in schizophrenia, affecting clinical outcomes. Cultural beliefs significantly shape caregivers’ attitudes toward schizophrenia, influencing EE levels. Studies among the Indian population found that focused psychosocial interventions reduce EE. The concept of EE should be reassessed considering evolving social contexts and psychopharmacological interventions.
Shetty et al. (Tue,) studied this question.