A Study to Assess and Compare the Expressed Emotions in Caregivers of Patients of Bipolar Affective Disorder and Obsessive Compulsive Disorder

Abstract

Introduction – Psychiatric illnesses are not only a chronic, despairing, stigmatized situation for the sufferers, but also produce a lot of physical, mental, emotional, social and financial burden for the family, specially the primary caregiver. This study was undertaken to assess and compare the level of Expressed Emotion (EE) among caregivers of patients of Bipolar Affective Disorder (BPAD) and Obsessive Compulsive Disorder (OCD). Methodology – 100 patients, 50 of BPAD (25 of Mania and 25 of Depression) and 50 of OCD were selected after screening. Their primary caregivers (100) were then included in the study. A socio-demographic profile and LEE (Level of Expressed Emotion scale) questionnaire were filled by each caregiver. The scores on the 60 questionnaire format of LEE scale were then assessed and compared between groups. Four sub-sets of EE were analyzed, namely Intrusiveness, Critical Attitude, Emotional Involvement and Tolerance of caregivers towards their patient. Results – Analysis showed that caregivers of patients of BPAD had higher level of EE than caregivers of patients of OCD. In the group of BPAD, higher EE was observed in caregivers of patients of BPAD with Mania than patients with BPAD Depression. Higher EE was indicated by more Intrusive and Critical Attitude and less Emotional Involvement and Tolerance. Conclusions – Mostly elderly, males, from rural, low socio-economic groups were the primary caregivers. Probably, patients of BPAD and especially with manic episodes were more negative and hostile because of their unpredictable and relapsing nature of illness, which in turn produced more frustration and negativity in their caregivers. Further studies are required to see the correlation between high EE of caregivers and patient outcomes.