Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand

Abstract Background Schizophrenia is a multifactorial disorder influenced by various biological and psychosocial factors. This study aimed to determine the characteristics and associated factors of expressed emotion (EE) among caregivers of individuals with schizophrenia. Methods From May to July 20...

Full description

Saved in:
Bibliographic Details
Main Authors: Tanaporn Kaewchum, Jarurin Pitanupong, Laddaporn Tepsuan, Puangsan Yakkaphan, Pakpoom Maneepongpermpoon
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Psychology
Subjects:
Online Access:https://doi.org/10.1186/s40359-025-02365-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832594325780824064
author Tanaporn Kaewchum
Jarurin Pitanupong
Laddaporn Tepsuan
Puangsan Yakkaphan
Pakpoom Maneepongpermpoon
author_facet Tanaporn Kaewchum
Jarurin Pitanupong
Laddaporn Tepsuan
Puangsan Yakkaphan
Pakpoom Maneepongpermpoon
author_sort Tanaporn Kaewchum
collection DOAJ
description Abstract Background Schizophrenia is a multifactorial disorder influenced by various biological and psychosocial factors. This study aimed to determine the characteristics and associated factors of expressed emotion (EE) among caregivers of individuals with schizophrenia. Methods From May to July 2024, a cross-sectional study was conducted with caregivers of individuals with schizophrenia across multiple hospitals in Southern Thailand. The study utilized four questionnaires: (1) Demographic inquiry, (2) The Thai Expressed Emotion Scale (TEES), (3) The Thai General Health Questionnaire (GHQ-12), and (4) The Zarit Burden Interview (ZBI). Data were analyzed using descriptive statistics. The groups analyzed were compared using the Analysis of Variance (ANOVA) or Kruskal-Wallis test, the Student t-test or Wilcoxon rank sum test, and the Chi-square test. Multiple logistic regression analysis was performed. Results In a survey of 200 caregivers, 70.5% were female. They had a median caregiving duration of 108 months, with an interquartile range (IQR) of 36 to 180 months. Notably, 51.0% of caregivers reported no mental health problems, as assessed by the GHQ-12, while 29.0% indicated experiencing severe burden. The median score on the TEES was 99.0, with an IQR of 84.7 to 109.0. Furthermore, 46.0% of caregivers reported TEES above the median score, indicating high levels of EE. There was also a significant correlation between caregiver burden and EE scores. Those experiencing severe burden had an EE score of 110.5 compared to 94.0 for those with no burden, which was statistically significant (p = 0.001). Multiple logistic regression analysis revealed that high EE among caregivers was associated with factors such as the patient’s duration of illness, caregiver occupation, and mental health status. Conclusion Nearly half of the caregivers of individuals with schizophrenia reported high levels of EE, with increased caregiver burden associated with higher EE levels. Factors such as the duration of the patient’s illness, caregiver occupation, and mental health status were also associated with higher EE. Moreover, caregivers’ emotional responses and expressions are complex and dynamic. Thus, focusing on providing support to caregivers can have a positive impact on the well-being of both caregivers and individuals with schizophrenia.
format Article
id doaj-art-2bc6b0d3a1964088bfbd954c2415e3b5
institution Kabale University
issn 2050-7283
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series BMC Psychology
spelling doaj-art-2bc6b0d3a1964088bfbd954c2415e3b52025-01-19T12:43:45ZengBMCBMC Psychology2050-72832025-01-0113111010.1186/s40359-025-02365-0Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern ThailandTanaporn Kaewchum0Jarurin Pitanupong1Laddaporn Tepsuan2Puangsan Yakkaphan3Pakpoom Maneepongpermpoon4Department of Psychiatry, Faculty of Medicine, Prince of Songkla UniversityDepartment of Psychiatry, Faculty of Medicine, Prince of Songkla UniversitySongkhla HospitalPattani HospitalPattani HospitalAbstract Background Schizophrenia is a multifactorial disorder influenced by various biological and psychosocial factors. This study aimed to determine the characteristics and associated factors of expressed emotion (EE) among caregivers of individuals with schizophrenia. Methods From May to July 2024, a cross-sectional study was conducted with caregivers of individuals with schizophrenia across multiple hospitals in Southern Thailand. The study utilized four questionnaires: (1) Demographic inquiry, (2) The Thai Expressed Emotion Scale (TEES), (3) The Thai General Health Questionnaire (GHQ-12), and (4) The Zarit Burden Interview (ZBI). Data were analyzed using descriptive statistics. The groups analyzed were compared using the Analysis of Variance (ANOVA) or Kruskal-Wallis test, the Student t-test or Wilcoxon rank sum test, and the Chi-square test. Multiple logistic regression analysis was performed. Results In a survey of 200 caregivers, 70.5% were female. They had a median caregiving duration of 108 months, with an interquartile range (IQR) of 36 to 180 months. Notably, 51.0% of caregivers reported no mental health problems, as assessed by the GHQ-12, while 29.0% indicated experiencing severe burden. The median score on the TEES was 99.0, with an IQR of 84.7 to 109.0. Furthermore, 46.0% of caregivers reported TEES above the median score, indicating high levels of EE. There was also a significant correlation between caregiver burden and EE scores. Those experiencing severe burden had an EE score of 110.5 compared to 94.0 for those with no burden, which was statistically significant (p = 0.001). Multiple logistic regression analysis revealed that high EE among caregivers was associated with factors such as the patient’s duration of illness, caregiver occupation, and mental health status. Conclusion Nearly half of the caregivers of individuals with schizophrenia reported high levels of EE, with increased caregiver burden associated with higher EE levels. Factors such as the duration of the patient’s illness, caregiver occupation, and mental health status were also associated with higher EE. Moreover, caregivers’ emotional responses and expressions are complex and dynamic. Thus, focusing on providing support to caregivers can have a positive impact on the well-being of both caregivers and individuals with schizophrenia.https://doi.org/10.1186/s40359-025-02365-0CaregiversExpressed emotionFamily burdenIndividuals with schizophrenia
spellingShingle Tanaporn Kaewchum
Jarurin Pitanupong
Laddaporn Tepsuan
Puangsan Yakkaphan
Pakpoom Maneepongpermpoon
Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand
BMC Psychology
Caregivers
Expressed emotion
Family burden
Individuals with schizophrenia
title Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand
title_full Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand
title_fullStr Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand
title_full_unstemmed Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand
title_short Expressed emotions among caregivers of individuals with schizophrenia and associated factors: a multihospital-based survey in Southern Thailand
title_sort expressed emotions among caregivers of individuals with schizophrenia and associated factors a multihospital based survey in southern thailand
topic Caregivers
Expressed emotion
Family burden
Individuals with schizophrenia
url https://doi.org/10.1186/s40359-025-02365-0
work_keys_str_mv AT tanapornkaewchum expressedemotionsamongcaregiversofindividualswithschizophreniaandassociatedfactorsamultihospitalbasedsurveyinsouthernthailand
AT jarurinpitanupong expressedemotionsamongcaregiversofindividualswithschizophreniaandassociatedfactorsamultihospitalbasedsurveyinsouthernthailand
AT laddaporntepsuan expressedemotionsamongcaregiversofindividualswithschizophreniaandassociatedfactorsamultihospitalbasedsurveyinsouthernthailand
AT puangsanyakkaphan expressedemotionsamongcaregiversofindividualswithschizophreniaandassociatedfactorsamultihospitalbasedsurveyinsouthernthailand
AT pakpoommaneepongpermpoon expressedemotionsamongcaregiversofindividualswithschizophreniaandassociatedfactorsamultihospitalbasedsurveyinsouthernthailand