Family expressed emotions, treatment adherence and symptom relapse among schizophrenia patients in Uganda

Abstract

Symptom relapse among schizophrenia patients has become a global concern and accounts for the majority (75%) of the readmission cases. Studies world-over indicate that in consistence to treatment regiments predicts disease relapse while the construct “Expressed Emotion (EE)” has been shown to play a role in this relapse in some cultures, especially the West. This study was aimed at establishing the relationship between Family Expressed Emotion, treatment adherence and symptom relapse among discharged schizophrenia patients at Butabika Hospital, Uganda. A descriptive correlational survey was carried out using a structured questionnaire, on 85 schizophrenia readmissions who had been discharged and were awaiting collection home at the recovery wards. Complete census on relapsed schizophrenia patients through convenient purposive sampling technique was used. Data were analysed and summarized using descriptive statistics, Spearman correlation and multiple regressions. The hypotheses were further tested using Fishers exact and Chi-square tests. Majority of the respondents were female of age-group 30-39 years with secondary school education and lived with significant others. Of the 85 relapsed respondents, majority experienced High levels of family EE and majority also were non-adherent to treatment regiments. Levels of family expressed emotion had no significant relationship with either nature of treatment adherence or with symptom relapse. Nature of Treatment adherence and symptom relapse were correlated, and when nature of treatment adherence and levels of perceived expressed emotion were merged together, they predicted symptom relapse. However, perceived expressed emotion, nature of treatment adherence and frequency of symptom relapse have indicated a significant relationship (p<.05) among schizophrenia patients at Butabika Hospital-Uganda. Therefore, Mental health professionals need to integrate family therapy interventions specifically ‘family interaction’ in the provision of mental health services and to Psycho-educate both “family and patient” on disease-course. Further studies on the precipitating and maintaining factors of family EE among relatives of schizophrenia patients need to be considered.