Psychoeducation for the families of patients with eating disorders and changes in expressed emotion: A preliminary study

Psychosocial variables such as expressed emotion (EE) have prognostic significance, and family psychoeducation has been developed to aid in the treatment of various psychiatric disorders. This study reports relationships among EE, family factors, and symptoms observed while conducting multifamily psychoeducation for eating disorders. Group sessions were held once a month for the relatives of patients with DSM-IV eating disorders, and the group met for five sessions that included both education and problem-solving. Thirty-seven relatives volunteered to participate in our program, and of these, 28 completed the program. EE (as measured by the Five-Minute Speech Sample [FMSS]), family function (as measured by the Family Adaptability and Cohesion Evaluation Scales [FACES]), the family's mental state (as measured by the Profile of Mood States [POMS]), and patient's symptoms (as measured by the Eating Disorder Evaluation Scales [EDES] and Global Assessment of Functioning [GAF] on clinician evaluations, and by the Anorexic Behavior Observation Scale [ABOS] assessment of the family) were administered at both the first and final sessions. The rates of high-EE relatives tended to decrease (especially high emotional overinvolvement [EOI]), and families' assessment of symptoms was also significantly improved. Twice-repeated multivariate analysis of variance (MANCOVA) showed that EOI, ABOS, and POMS scores were changed significantly during the sessions. Psychoeducation for the family members of patients with eating disorders might help lower distress and encourage positive interactions within the family. EE is an important measure in evaluations of psychoeducation. However, a randomized, controlled trial is needed to clarify the efficacy of this treatment.