A comparative study of expressed emotions in caregivers of patients with schizophrenia and bipolar affective disorder

Abstract

Background: While expressed emotions (EEs) have been extensively explored in schizophrenia, there is a notable scarcity of literature concerning their study in bipolar affective disorder (BPAD). Few studies have directly compared EEs in these two psychiatric conditions. This research addresses this gap by examining the nuanced dynamics of emotional expression within familial and social contexts in both schizophrenia and BPAD. Hence, this study was done to investigate and compare the EEs in caregivers of patients with schizophrenia and BPAD. Methodology: Sociodemographic data were collected in intake pro forma from caregivers of outpatient and inpatients with a diagnosis of schizophrenia and BPAD as per the International Classification of Diseases 10. Primary caregivers of patients who met inclusion criteria were administered the Family Emotional Involvement and Criticism Scale (FEICS). Patients were administered the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), and Hamilton Depression Rating Scale to study psychopathology. Descriptive statistics such as mean, standard deviation (SD), and unpaired t-test were applied for continuous variables. Chi-square for categorical data, Spearman correlation test was used to study the correlation between the psychopathology of patients and EEs among caregivers. Results: The mean score of the perceived criticism subscale of FEICS of caregivers of BPAD was found to be 2.22 ± 0.68 SD and the emotional involvement subscale was 1.54 ± 0.58 SD. The mean score of the perceived criticism subscale of schizophrenia caregivers was 1.72 ± 0.73 and the emotional involvement subscale was 1.34 ± 0.471. The EE score across both perceived criticism and emotional involvement subscales was more in BPAD than in schizophrenia (P ≤ 0.001). There was a statistically significant positive correlation between the YMRS score and perceived criticism subscale scores (P ≤ 0.001), and there was also a statistically significant positive correlation between PANSS scores and perceived criticism and emotional involvement subscales of EE (P ≤ 0.001). No association was found between the severity of EE and sociodemographic factors of caregivers. Conclusions: The presence of high scores of EE among caregivers of BPAD signifies psychopathology in the family. This calls for providing psychosocial measures for caregivers so that they can take care of their ill family members effectively.

Keywords

• bipolar affective disorder
• expressed emotion
• primary caregiver
• schizophrenia