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Article: The predictive power of expressed emotion and its components in relapse of schizophrenia: a meta-analysis and meta-regression

TitleThe predictive power of expressed emotion and its components in relapse of schizophrenia: a meta-analysis and meta-regression
Authors
KeywordsExpress emotion
family caregiver
psychosis
relapse
Issue Date2021
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 2021, v. 51 n. 3, p. 365-375 How to Cite?
AbstractBackground: Schizophrenia is a longstanding condition and most patients experience multiple relapse in the course of the condition. High expressed emotion (HEE) has been found to be a predictor of relapse. This meta-analysis and meta-regression examined the association of global EE and relapse specifically focusing on timing of relapse and EE domains. Methods: Random-effects model was used to pool the effect estimates. Multiple random-effects meta-regression was used to compute the moderator analysis. Putative effect moderators including culture, EE measurements, age, length of condition and study quality were included. Results: Thirty-three prospective cohort studies comprising 2284 patients were included in the descriptive review and 30 studies were included for meta-analysis and meta-regression. Findings revealed that global HEE significantly predicted more on early relapse (⩽12 months) [OR 4.87 (95% CI 3.22–7.36)] than that on late relapse (>12 months) [OR 2.13 (95% CI 1.36–3.35)]. Higher level of critical comments (CC) significantly predicted relapse [OR 2.22 (95% CI 1.16–4.26)], whereas higher level of warmth significantly protected patients from relapse [OR 0.35 (95% CI 0.15–0.85)]. None of the moderators included significantly change the results. Conclusions: These findings indicate that there is a dynamic interaction between EE-relapse association with time, and CC and warmth are the two important EE domains to influence relapse among patients with schizophrenia. Results also confirmed the foci of family interventions on reducing CC and improving warmth in relationship.
Persistent Identifierhttp://hdl.handle.net/10722/296341
ISSN
2023 Impact Factor: 5.9
2023 SCImago Journal Rankings: 2.768
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMa, CF-
dc.contributor.authorChan, SKW-
dc.contributor.authorChung, YL-
dc.contributor.authorNg, SM-
dc.contributor.authorHui, CLM-
dc.contributor.authorSuen, YN-
dc.contributor.authorChen, EYH-
dc.date.accessioned2021-02-22T04:53:55Z-
dc.date.available2021-02-22T04:53:55Z-
dc.date.issued2021-
dc.identifier.citationPsychological Medicine, 2021, v. 51 n. 3, p. 365-375-
dc.identifier.issn0033-2917-
dc.identifier.urihttp://hdl.handle.net/10722/296341-
dc.description.abstractBackground: Schizophrenia is a longstanding condition and most patients experience multiple relapse in the course of the condition. High expressed emotion (HEE) has been found to be a predictor of relapse. This meta-analysis and meta-regression examined the association of global EE and relapse specifically focusing on timing of relapse and EE domains. Methods: Random-effects model was used to pool the effect estimates. Multiple random-effects meta-regression was used to compute the moderator analysis. Putative effect moderators including culture, EE measurements, age, length of condition and study quality were included. Results: Thirty-three prospective cohort studies comprising 2284 patients were included in the descriptive review and 30 studies were included for meta-analysis and meta-regression. Findings revealed that global HEE significantly predicted more on early relapse (⩽12 months) [OR 4.87 (95% CI 3.22–7.36)] than that on late relapse (>12 months) [OR 2.13 (95% CI 1.36–3.35)]. Higher level of critical comments (CC) significantly predicted relapse [OR 2.22 (95% CI 1.16–4.26)], whereas higher level of warmth significantly protected patients from relapse [OR 0.35 (95% CI 0.15–0.85)]. None of the moderators included significantly change the results. Conclusions: These findings indicate that there is a dynamic interaction between EE-relapse association with time, and CC and warmth are the two important EE domains to influence relapse among patients with schizophrenia. Results also confirmed the foci of family interventions on reducing CC and improving warmth in relationship.-
dc.languageeng-
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM-
dc.relation.ispartofPsychological Medicine-
dc.rightsPsychological Medicine. Copyright © Cambridge University Press.-
dc.rightsThis article has been published in a revised form in Psychological Medicine [http://doi.org10.1017/S0033291721000209]. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © The Author(s), 2021. Published by Cambridge University Press-
dc.subjectExpress emotion-
dc.subjectfamily caregiver-
dc.subjectpsychosis-
dc.subjectrelapse-
dc.titleThe predictive power of expressed emotion and its components in relapse of schizophrenia: a meta-analysis and meta-regression-
dc.typeArticle-
dc.identifier.emailChan, SKW: kwsherry@hku.hk-
dc.identifier.emailNg, SM: ngsiuman@hku.hk-
dc.identifier.emailHui, CLM: christyh@hku.hk-
dc.identifier.emailSuen, YN: suenyn@hku.hk-
dc.identifier.emailChen, EYH: eyhchen@hku.hk-
dc.identifier.authorityChan, SKW=rp00539-
dc.identifier.authorityNg, SM=rp00611-
dc.identifier.authorityHui, CLM=rp01993-
dc.identifier.authoritySuen, YN=rp02481-
dc.identifier.authorityChen, EYH=rp00392-
dc.description.naturepostprint-
dc.identifier.doi10.1017/S0033291721000209-
dc.identifier.pmid33568244-
dc.identifier.scopuseid_2-s2.0-85100792245-
dc.identifier.hkuros321389-
dc.identifier.volume51-
dc.identifier.issue3-
dc.identifier.spage365-
dc.identifier.epage375-
dc.identifier.isiWOS:000627866800002-
dc.publisher.placeUnited Kingdom-

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