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Predictors of expressed emotion, burden and quality of life in relatives of Mexican patients with psychosis

Authors

  • L. Gómez-de-Regil PhD,

    Research Unit Coordinator, Graduated PhD Student, Tenured Lecturer, Corresponding author
    1. Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, México
    2. Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona
    • Correspondence:

      L. Gómez-de-Regil

      Hospital Regional de Alta Especialidad de la Península de Yucatán

      Kilómetro 8.5 Carretera Mérida-Cholul s/n

      Mérida

      Yucatán 97134

      México

      E-mail: gomezderegil@gmail.com

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  • T. R. Kwapil PhD,

    Professor, Adjunct Associate Professor
    1. Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
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  • N. Barrantes-Vidal PhD

    Graduated PhD Student, Tenured Lecturer, Research Consultant, Researcher, Professor, Adjunct Associate Professor
    1. Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona
    2. Sant Pere Claver – Fundació Sanitària. Vila i Vilà, Barcelona
    3. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
    4. Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
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Abstract

Accessible summary

  • Families play an important role in the recovery of mental health patients providing daily informal care. Without support from and an alliance with clinical professionals, family members may feel overwhelmed by the challenge of having a relative with a mental disorder.
  • The study explores whether the relatives' own feelings of burden, expressed emotion and quality of life can be affected not only by the symptoms of their ill relative but also by how relatives themselves perceive the illness and how psychologically distressed they feel. From a public psychiatric hospital located in Mexico, 65 patients with psychosis were interviewed along with their closest caregiver.
  • Feeling psychologically distressed increases relatives' burden, expressed emotion and negatively affects their quality of life. Regardless of the patient's mental health status, perceiving the illness as chronic increases relatives' burden. Moreover, when relatives believe that they, rather than treatment or the patient, control or influence the illness, they feel more burden, and their quality of life is poorer. The quality of life of the relatives is also disrupted by their perception of illness as affecting their own lives as well as patients'.
  • Results underscore the relatives' need of support to overcome their own distress and concerns about the illness, for the psychological well-being of both patients and relatives.

Abstract

Expressed emotion, burden and quality of life of relatives received attention because of the increasing interest in predicting and preventing relapse in psychotic patients; but they have subsequently acquired interest of their own as important aspects of families' psychological well-being. The study explores whether the psychological distress and illness perception of a sample of relatives of Mexican patients with psychosis can predict their levels of expressed emotion, burden and quality of life above patients' clinical and functional status. Sixty-five patient–relative dyads were interviewed. Relatives self-reported on expressed emotion, burden, quality of life, psychological distress and illness perception. Patients' clinical and functional status was rated by an interviewer. Pearson correlations and hierarchical multiple linear regressions were used for statistical analyses. Patients' functional status and relatives' psychological distress were significantly associated with expressed emotion, burden and quality of life. Patients' clinical status and relatives' illness perception were most strongly related to expressed emotion and burden. Relatives' psychological distress and illness perception dimensions predicted both burden and quality of life, over and above patients' clinical and functional status. Results underscore the relatives' need of support to overcome their own distress and concerns about the illness, for the psychological well-being of both patients and relatives.

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