Expressed Emotion in relatives of persons with dementia: a systematic review and meta-analysis

Aging Ment Health. 2017 Feb;21(2):113-124. doi: 10.1080/13607863.2015.1111863. Epub 2015 Nov 16.

Abstract

Objectives: Expressed Emotion (EE) refers to a number of key aspects of interpersonal relationships which have been shown to relate to outcomes in relatives of people with health conditions.

Design: A systematic review and meta-analysis of EE and outcomes in relatives of persons with dementia is reported. Potential research studies were identified via a search of three electronic databases; PsychINFO, MEDLINE and the Web of Science between 1960 and 2015.

Results: We reviewed 12 studies investigating correlations between EE and well-being in relatives of patients with dementia. Factors hypothesised to influence EE including attributions, social support, coping strategies and relationship quality were also reviewed.

Conclusion: High-EE relatives were found to have increased levels of burden (Z = 6.967, P < 0.001) and greater levels of depression (Z = 5.842, P < 0.001). Compared to low-EE relatives, high-EE relatives were more likely to attribute the patient's problems to factors that were personal to and controllable by the patient. Relatives with less social support, inefficient coping strategies and a poor relationship with the patients, were more likely to be classified as high-EE.

Keywords: Expressed Emotion; burden; dementia; psychological well-being.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adaptation, Psychological
  • Caregivers / psychology
  • Dementia / psychology*
  • Depression / psychology
  • Expressed Emotion*
  • Family / psychology*
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Quality of Life
  • Social Support