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Life events, relatives' Expressed Emotion and maintenance neuroleptics in schizophrenic relapse

  • Julian Leff (a1), Liz Kuipers (a1), Ruth Berkowitz (a1), Christine Vaughn (a1) and David Sturgeon (a1)...

Data from two studies, one naturalistic and the other a controlled trial, were analysed to clarify the relationships between independent life events, Expressed Emotion of a key relative, maintenance neuroleptics and the relapse of schizophrenia. It was found that patients in the community who are unprotected by medication are vulnerable either to acute stress in the form of life events or to chronic stress in the form of living with a high Expressed Emotion relative. Patients on regular medication are protected against one or other stress, but are very likely to relapse if the two forms of stress occur together. A model of schizophrenic susceptibility to environmental stress is constructed to incorporate these observations.

Corresponding author
1Address for correspondence: Dr J. P. Leff, MRC Social Psychiatry Unit, Friern Hospital, Friern Barnet Road, London N11 3BP.
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J. L. T. Birley & G. W. Brown (1970). Crises and life changes preceding the onset or relapse of acute schizophrenia: clinical aspects. British Journal of Psychiatry 116, 327333.

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J. P. Leff , L. Kuipers , R. Berkowitz , R. Eberlein-Vries & D. Sturgeon (1982). A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry 141, 121134.

D. Sturgeon , L. Kuipers , R. Berkowitz , G. Turpin & J. P. Leff (1981). Psychophysiological responses of schizophrenic patients to High and Low Expressed Emotion relatives. British Journal of Psychiatry 138, 4045.

C. Vaughn & J. P. Leff (1976 a). The influence of family and social factors on the course of psychiatric illness. British Journal of Psychiatry 129, 125137.

C. Vaughn & J. P. Leff (1976 b). The measurement of Expressed Emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology 15, 157165.

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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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