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...
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2025-01-01
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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. |
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language | English |
publishDate | 2025-01-01 |
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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 |
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