[Update on "expressed emotions"].

Abstract

The present article is meant to sum up the current state of scientific knowledge with regard to the concept of "Emotional Expression" and its very implementation in the clinical and therapeutical field which are well-known in anglo-saxon countries but very little applied and known in France. "Emotional Expression" (EE), which came out of research and studies undertaken by Brown (1959) and later on, Vaughn and Leff (1976), defines interaction between a schizophrenic patient and his close environment according to 3 criterium: judgmental comments and criticism, hostility, emotional over-involvement. Family surroundings are characterized by strong EE or weak EE according to the frequency and the quantity of the measures during a typical standard family-interview: the Camberwell Family Interview (CFI). A strong EE is considered as being a non-specific factor. "Emotional Expression" proves to be a predictable indication for relapse in terms of psychiatric affluence (positive symptoms), hospitalization rate and psycho-social adjustment process. The possibilities of forecasting do not concern specifically schizophrenia as the relation between family climate and relapse can be observed in other mental pathology as well. The psycho-educational approach which is induced by this research trend is based on a concept of a partnership between the patients's family and the patient. The purpose in fact is to bring about changes within the relationship of the patient and his environment so as to reduce judgmental criticism, hostility and emotional over-involvement (information programs concerning etiology, therapeutical strategies in view of improving understanding of the illness and to reorganize proper family relationship). The advantage of such a concept which is well-known lies in the fact that it helps to find out those family surroundings with strong EE who represent factors of relapse for psychiatric patients and to suggest therefore therapeutical treatment, the purpose of which should be defined together with all those concerned namely, the patient, the family, the therapeutist so as to intervene during the evolution of the illness. The literary bibliographical review which we have made lead us to find the existence of a wide field of research with results showing clearly the predictable aspects of EE in the illness process. In this way, new approaches in the "intake" of schizophrenic patients and their families are clearly defined.