article · International Journal of Recent Advances in Multidisciplinary Topics
This randomised controlled trial investigated the impact of psychoeducation on expressed emotion (EE) among caregivers of individuals with schizophrenia in Maiduguri, Nigeria, and its association with patient outcomes. Schizophrenia affects millions globally, with high EE from caregivers being a known factor in patient relapse. The study involved 62 patient-caregiver pairs, with an intervention group receiving three psychoeducation sessions and a control group receiving standard treatment. Researchers found that 53.2% of caregivers initially exhibited high EE. Psychoeducation significantly reduced caregiver EE levels after two weeks. However, there was no significant difference in patient relapse rates between the groups after six months. The findings suggest that family psychoeducation effectively reduces caregiver EE and may improve overall caregiver and patient outcomes.
Schizophrenia places a substantial burden on healthcare systems and families. Understanding how to support caregivers and reduce factors like high expressed emotion is crucial for improving patient well-being and potentially lowering relapse rates, ultimately enhancing mental health care.
This research demonstrates the effectiveness of family psychoeducation as an intervention to reduce caregiver expressed emotion in schizophrenia. It could be adopted by mental health organisations and healthcare providers to improve support programmes for caregivers, potentially leading to better patient management and reduced burden on families. This is an applied intervention, tested in a clinical trial, suggesting it is ready for wider implementation in clinical practice.
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Schizophrenia affects about 24 million people worldwide, representing 1 in 300 individuals (0.32%). A 2010 Nigerian study reported a lifetime prevalence of 2.1%. Although relatively low, the disorder imposes a significant and growing burden on healthcare systems in low- and middle-income countries due to population growth and aging. Despite treatment advances, relapse rates remain high, influenced by prolonged illness duration, medication non-adherence, substance use, stressful life events, comorbid mental illness, and psychosocial factors such as expressed emotion (EE). High EE, marked by critical comments, hostility, and emotional over-involvement from caregivers, is strongly linked to relapse in schizophrenia and evidence indicates that psychoeducation reduces high EE. Thus, family psychoeducation is a vital intervention to lower relapse rates and ease the global schizophrenia burden. The aim of the study is to evaluate the effect of psychoeducation on the level of expressed emotion among caregivers of individuals with schizophrenia and its associated patient outcome. The study was a randomized controlled trial to evaluate the effect of psychoeducation on caregiver EE levels and patient outcomes among individuals with schizophrenia attending the Federal Neuropsychiatric Hospital, Maiduguri. Sixty-two patient-caregiver pairs, diagnosed using the MINI, were randomized into intervention and control groups via permuted block randomization. Baseline assessments employed the Levels of Expressed Emotion Scale (LEES) and Positive and Negative Syndrome Scale (PANSS). The intervention group participated in three sessions of family psychoeducation, while the control group received standard treatment. Post-intervention assessments were conducted at 2 weeks and 6 months. The prevalence of high expressed emotion (EE) was 53.2%. Psychoeducation significantly reduced EE levels after 2 weeks compared with the control group (mean difference = 9.00, p < 0.001; Cohen's d = 1.001). However, relapse rates (3.2%) did not differ significantly between the groups after 6 months. Family psychoeducation effectively reduced EE and may improve caregiver and patient outcomes.
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DOI: 10.65138/ijramt.2026.v7i8.3306
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