首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到10条相似文献,搜索用时 125 毫秒
1.
We investigated the validity of expressed emotion (EE) in Israel. The study sample consisted of 108 patients with schizophrenia and 15 with schizoaffective disorder, and their key relatives. EE was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism and emotional overinvolvement. Patients were rated with the Brief Psychiatric Rating Scale (BPRS) at admission, at discharge, and 6 months after discharge. Readmissions were determined over a 9-month period. High EE and particularly high criticism were significantly associated with poorer outcome (higher rate of and earlier readmissions, and higher BPRS score at followup) and worse illness course (higher annual number of prior psychiatric hospital admissions). Odds ratios between high EE and high criticism and readmission were 2.6 and 3.5, respectively. The strongest predictor of earlier readmission was the interaction of high criticism x poor compliance with medication. The results converge to further confirm the notion that familial EE is a valid crosscultural predictor of the clinical course of schizophrenia. Moreover, EE has predictive power in very chronic samples. Criticism appears to be the crucial EE component linked with short-term outcome. Treatment aimed at reducing high criticism is warranted. The FMSS appears to have predictive validity.  相似文献   

2.
The role that the involvement of parents may play in the treatment outcome of their children with anxiety disorders is still under debate. Some studies dealing with other disorders have examined the role that the expressed emotion (EE) construct (parental overinvolvement, criticism and hostility) may play in treatment outcome and relapse. Given that some of these aspects have been associated with social anxiety for a long time, it was hypothesized that EE may be associated with lower treatment outcome. The sample was composed of 16 adolescents who benefited from a school-based, cognitive-behavioural intervention aimed at overcoming social anxiety. Then, parents were classified with high or low EE. The results revealed that the adolescents whose parents had low EE showed a statistically significant reduction of their social anxiety scores at posttest, as opposed to adolescents of parents with high expressed emotion. These findings suggest that parental psychopathology (parents with high EE) should be taken into consideration to prevent poor adolescent treatment outcome.  相似文献   

3.
OBJECTIVE: The purpose of this study was to compare clinical and service utilization profiles of adolescents admitted to inpatient treatment with and without a psychotropic medication regimen, and estimate correlates of medication use separately for the two groups. METHOD: Comprehensive data on clinical characteristics and service utilization of 517 adolescents enrolled in Medicaid who were admitted to three inpatient hospitals (one for-profit and two nonprofit) in a mid-Atlantic state were used. Medication correlates were examined with bivariate statistics (chi-square and t-test) and multivariate logistic regressions. RESULTS: Psychotropic medication was prescribed for the majority (90.5%) of adolescents at discharge. During their inpatient stay, 76.3% of the youths who were not on medication at admission (n = 190) initiated medication use, and 45% admitted with prior medication (n = 327) had a medication change. Adolescents admitted with and without medication differed on all sociodemographic and clinical characteristics except age, suicidality, and hospital. Controlling on demographic, clinical, and service history characteristics, hospital setting was the only correlate significantly associated with both initiation and change. CONCLUSIONS: Institutional factors may be more important than clinical factors in appraising medication patterns in inpatient settings. Interventions to ensure the development and implementation of medication management guidelines may need to be tailored to the climate and culture of the provider organization as well as directly to individual practitioners, parents or adolescents themselves.  相似文献   

4.
The relationships between expressed emotion (EE), affective style (AS) and communication deviance (CD) were studied during hospitalization and after discharge. EE was measured with both the Camberwell Family Interview (CFI) and the Five-Minutes Speech Sample (FMSS). The study subjects were patients with recent-onset schizophrenia and related disorders, who were consecutively admitted to an in-patient unit for adolescents, and their parents. The results revealed that CFI/EE was significantly correlated with AS criticism scores during hospitalization, but did not predict AS scores after discharge. FMSS/EE correlated significantly with AS criticism when both measures were administered after discharge. During hospitalization, FMSS/EE was not significantly correlated with AS. No consistent relationship was found between CD and both affective factors (EE and AS). It is concluded that EE and AS overlap with regard to level of criticism when both measures are administered over a short period of time and independent of the time of assessment. In addition, the results indicate that affective and communication factors identify independent family attributes.  相似文献   

5.
ObjectiveFamily interventions have been found to be effective in pediatric bipolar disorder (BD). This study examined the moderating effects of parental expressed emotion (EE) on the 2-year symptomatic outcomes of adolescent BD patients assigned to family-focused therapy for adolescents (FFT-A) or a brief psychoeducational treatment (enhanced care [EC]).MethodA referred sample of 58 adolescents (mean age 14.5 ± 1.6 years, range 13-17 years) with BD I, II, or not otherwise specified was randomly allocated after a mood episode to FFT-A or EC, both with protocol pharmacotherapy. Levels of EE (criticism, hostility, or emotional overinvolvement) in parents were assessed through structured interviews. Adolescents and parents in FFT-A underwent 21 sessions in 9 months of psychoeducation, communication training, and problem-solving skills training, whereas adolescents and parents in EC underwent 3 psychoeducation sessions. Independent “blind” evaluators assessed adolescents' depressive and manic symptoms every 3 to 6 months for 2 years.ResultsParents rated high in EE described their families as lower in cohesion and adaptability than parents rated low in EE. Adolescents in high-EE families showed greater reductions in depressive and manic symptoms in FFT-A than in EC. Differential effects of FFT-A were not found among adolescents in low-EE families. The results could not be attributed to differences in medication regimens.ConclusionsParental EE moderates the impact of family intervention on the symptomatic trajectory of adolescent BD. Assessing EE before family interventions may help determine which patients are most likely to benefit from treatment. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(6):643-651.  相似文献   

6.
Expressed emotion (EE) is an established factor in short-term relapse in schizophrenia. However, data on its long-term predictive ability are scarce. We extended our short-term investigation over 7 years' followup. The study population consisted of 108 patients, 93 with schizophrenia and 15 with schizoaffective disorder. EE of the key relatives was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism (CR) and emotional overinvolvement (EOI). High CR was associated with earlier first and second readmissions (Breslow p = 0.002 and 0.04, respectively). High CR was associated with a higher rate of readmissions (p = 0.01) and a longer hospital stay (p = 0.02) compared with low CR. Both compliance with pharmacotherapy and the interaction of high-CR x poor compliance were additional contributors to time to first readmission. This study is the first to demonstrate the prolonged predictive validity of EE. Our results support the value of CR as a prognostic indicator of the course of schizophrenia. The FMSS appears to have predictive power in respect to psychiatric hospitalization. Therapies aimed at lowering high EE seem warranted as a long-term preventive approach.  相似文献   

7.
Little is known of the concordance between ratings of expressed emotion (EE) derived from the Camberwell Family Interview (CFI) and Five-minute Speech Sample (FMSS) for parents of children with behaviour problems. Concordance between CFI and FMSS ratings of EE was assessed prior to intervention and compared to parent-rated behaviour after intervention, at follow-up, 12 months later. Female primary caretakers of 75 children (3-10 years) showing behavioural difficulties were interviewed using FMSS and CFI. Interviews were coded independently by criterion-standard raters. Using CFI, 57 families were classified high EE, and 18 low EE. Using FMSS, 65 families were classified high EE and 10 low EE. 55/75 pairs of ratings (73%) were the same (high, n = 51: low, n = 4) and 20 mothers (27%) were allocated different EE status (Kappa = 0.14, n.s.). The FMSS ratings at initial interview appeared more closely related to behaviour rating at follow-up than CFI. Further investigation is required to establish comparability of CFI and FMSS results for carers of children.  相似文献   

8.
Expressed emotion (EE) has been shown in various countries to be a good predictor of the clinical course of a patient's mental illness. Because the traditional EE interview requires considerable time and effort, this study examined the reliability of a method called the five-minute speech sample (FMSS) for assessing EE. The samples of 65 subjects were rated by the FMSS-EE coding system, and the interrater reliability among four authorized raters was investigated. Of these 65 samples, 10 (15%) were rated as high-EE (high critical, 6%; high emotional over-involvement (EOI), 9%), and 19 (29%) were rated as borderline (b-)-high-EE (b-critical, 15%; b-EOI, 14%). The intraclass correlation coefficient (ICC) was 0.91 for the overall category, 0.74 for criticism, 0.85 for EOI, 0.63 for b-critical and 0.54 for b-EOI. The FMSS was shown to be reliable for the assessment of EE, even outside of Western countries. However, the lower agreement in the subcategories of EOI and b-critical has to be considered as a limitation of this brief method.  相似文献   

9.
Purpose of this study is to identify predictors of the length of stay (LOS) in child and adolescent psychiatry (CAP) and the success of inpatient treatment. All child and adolescent inpatients that had been dismissed over a year's time from a non-university hospital after a medium-length-treatment were rated by their therapists (crisis interventions for < 2 weeks excluded). The group featured a low drop-out-rate (9.8%) and a high percentage of "problematic patients". The ICD-10 diagnoses were irrelevant for the prediction of LOS and success of treatment. The Global Assessment of Function scale (axis VI) correlated significantly with LOS, and functioning in all areas improved with a longer LOS. By the degree of initial psychopathology therapeutic success as well as LOS could be predicted fairly well. Concerning adolescents, motivation for treatment and the degree of cooperation both correlated with LOS and improvement, which implies the importance of their participation. For children under 12, cumulated psychosocial adversities (axis V) predicted a less positive outcome, cooperation of parents and patients raised the chance of success. Shortened lengths of stay will not lead to comparable success. As a system like DRGs for reimbursement of hospitalization in CAP will not prove to be efficient, other variables deserve more attention in future health economy planning. More intervening variables, such as psychosocial adversities, motivation, and cooperation have to be considered.  相似文献   

10.
Families of two subgroups of adolescents in the community, at high and low risk for major depressive disorder, were compared on the McMaster Family Assessment Device (FAD) and the General Health Questionnaire (GHQ). Families of high-risk adolescents who became depressed by follow-up at one year were comared with other families of high-risk subjects. The only significant difference on FAD ratings for high- and low-risk groups was on the sub-scale Roles as reported by mothers. FAD ratings showed that, compared with mothers, fathers of high-risk adolescents held significantly worse views of their families' functioning on the sub-scales Problem Solving. Affective Responsiveness and Behaviour Control. There were no such differences between low-risk parents. Both mothers and fathers of high-risk adolescents reported their own mental health as significantly poorer than mothers and fathers of low-risks. The mental health of mothers in the high-risk group only was significantly associated with their FAD ratings. Adolescents rated their families as significantly worse on the FAD than their parents and the lower their mood and self-esteem, the worse they rated their families on the FAD. Subsequent MDD in adolescents by follow-up at one year was not associated with the FAD scores of any family member, nor with either parent's mental health. Accepted: 26 January 2001  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号