| Autor: |
Ferentinos P; 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 12 462 Athens, Greece., Douki S; Department of Psychiatry, 'Evangelismos' General Hospital, 106 76 Athens, Greece., Yotsidi V; Department of Psychology, Panteion University of Social and Political Sciences, 176 71 Athens, Greece., Kourkouni E; Center for Clinical Epidemiology and Outcomes Research, 15 451 Athens, Greece., Dragoumi D; Department of Psychiatry, 'Evangelismos' General Hospital, 106 76 Athens, Greece., Smyrnis N; 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 12 462 Athens, Greece., Douzenis A; 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 12 462 Athens, Greece. |
| Abstrakt: |
Expressed emotion (EE) toward patients with schizophrenia is typically reported to be lower in psychiatric halfway houses than in families. This is the first study directly comparing EE between these settings and investigating the pathways mediating EE differences. We included 40 inpatients in halfway houses and 40 outpatients living with their families and recorded 22 psychiatric nurses' and 56 parents' EE, respectively, through Five Minutes Speech Samples. Each inpatient was rated by 2-5 nurses and each outpatient by 1-2 parents. As EE ratings had a multilevel structure, generalized linear mixed models were fitted, adjusting for patient-related confounders and caregiver demographics. Mediatory effects were investigated in multilevel structural equation models. Outpatients were younger, less chronic, and better educated, with higher negative symptoms and perceived criticism than inpatients. Nurses were younger and better educated than parents. Before adjustment, EE rates were equally high across settings. After adjusting for patient-related confounders, emotional overinvolvement was significantly higher in parents. However, after also adjusting for caregiver demographics, only criticism was significantly higher in nurses. Patients' age, negative symptoms, and perceived criticism and caregivers' age and sex significantly mediated EE group differences. Our findings highlight pathways underlying EE differences between halfway houses and families and underscore the importance of staff and family psychoeducation. |
