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I. One-Year Effects of a Controlled Study on Relapse and Expressed Emotion

Gerard E. Hogarty, MSW; Carol M. Anderson, PhD; Douglas J. Reiss, PhD; Sander J. Kornblith, PhD; Deborah P. Greenwald, PhD; Carol D. Javna, PhD; Michael J. Madonia; Environmental/Personal Indicators in the Course of Schizophrenia Research Group

Arch Gen Psychiatry. 1986;43(7):633-642.

Abstract
• Relapse rates averaging 41% in the first year after discharge among schizophrenic patients receiving maintenance neuroleptic treatment led to the development of two disorderrelevant treatments: a patient-centered behavioral treatment and a psychoeducational family treatment. Following hospital admission, 103 patients residing in high expressed emotion (EE) households who met Research Diagnostic Criteria for schizophrenia or schizoaffective disorder were randomly assigned to a two-year aftercare study of (1) family treatment and medication, (2) social skills training and medication, (3) their combination, or (4) a drug-treated condition. First-year relapse rates among those exposed to treatment demonstrate a main effect for family treatment (19%), a main effect for social skills training (20%), and an additive effect for the combined conditions (0%) relative to controls (41%). Effects are explained, in part, by the absence of relapse in any household that changed from high to low EE. Only the combination of treatment sustains a remission in households that remain high in EE. Continuing study, however, suggests a delay of relapse rather than prevention.

Author Affiliations
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine.

Footnotes
Accepted for publication Oct 9, 1985.

Reprint requests to Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA 15213-2593 (Mr Hogarty).

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