Empathy plays a central role in social relationships, and lack of empathy has been suggested as part of expressed emotion in the relatives of patients with schizophrenia. The aim of this research is to measure empathy in the relatives of schizophrenia patients and to establish the relationship between lack of empathy and relapse. Eighty schizophrenia patients were followed up in a 2-year prospective cohort study. Relatives' empathy, defined as the ability to perceive the patient's mood state, was measured at the beginning of the study with a questionnaire given after a 10-minute interaction between the patient and his or her relative. Several other attitudinal, clinical, and social variables were also measured. A significant relationship was found between poor empathic attitude and relapse. Lack of treatment compliance, negative symptoms, unemployment, and poor premorbid adjustment were also associated with relapse. In a multivariate analysis, the association between poor empathic attitude and relapse was maintained. Statistical control of the relatives' critical attitude showed that each kind of attitude predicts relapse independently.