Psychological Medicine

The family and compliance in schizophrenia: the influence of clinical variables, relatives' knowledge and expressed emotion

a1 Manchester Mental Health Partnership; Academic Division of Clinical Psychology, University of Manchester; and Department of Clinical Psychology, Tameside General Hospital, Manchester


Background. A variety of factors are related to compliance with medication in schizophrenia, but little attention has been paid to the role of families. Carers' knowledge or expressed emotion (EE) may be related to compliance. The aim of the present study was to evaluate the relevance of these two factors, as well as their relationships with other variables for the prediction of compliance.

Method. A sample of patient–carer pairs (N=79) involved in a family intervention for schizophrenia trial was recruited. Compliance, symptoms, social functioning and attitudes to their carers were assessed in patients. Carers' EE, knowledge and psychopathology were also evaluated.

Results. A number of factors were related to compliance, including carers' EE and patients' psychotic symptoms, which contributed independently to not taking medication. Carers' knowledge about schizophrenia and other groups of symptoms was not related to compliance.

Conclusions. EE may be an important factor to account for in the understanding of patients' compliance and the direction of the relationship between EE and compliance should be the subject of further study.

c1 Address for correspondence: Dr W. Sellwood, Department of Clinical Psychology, Manchester Mental Health Partnership, Laureate House, New Mental Health Unit, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT.

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