PMID- 29661524
OWN - NLM
STAT- MEDLINE
DCOM- 20190311
LR  - 20190311
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 199
DP  - 2018 Sep
TI  - Expressed emotion as a predictor of the first psychotic episode - Results of the 
      European prediction of psychosis study.
PG  - 346-352
LID - S0920-9964(18)30171-3 [pii]
LID - 10.1016/j.schres.2018.03.019 [doi]
AB  - OBJECTIVE: To investigate the impact of expressed emotion (EE) on the risk of 
      developing the first psychotic episode (FEP). METHOD: The European Prediction of 
      Psychosis Study (EPOS) investigated 245 patients who were at clinical high risk 
      (CHR) of psychosis. The predictive value of EE alone and as a part of the 
      multivariate EPOS model was evaluated. RESULTS: "Perceived irritability", a 
      domain of the Level of Expressed Emotion Scale (LEE), was found to be predictive 
      for the First Psychotic Episode (FEP), even as an individual variable. 
      Furthermore, it was selected in the multivariate EPOS prediction model, thereby 
      replacing two of the original predictor variables. This led to an improved 
      revised version that enabled the identification of three significantly different 
      risk classes with a hazard rate of up to 0.911. CONCLUSIONS: CHR subjects who 
      perceive the most important person in their individual social environment to be 
      limited in their stress coping skills had a higher risk of conversion to the 
      first psychotic episode. The importance of this risk factor was further 
      demonstrated by an improvement of risk estimation in the original EPOS predictor 
      model. Perceiving a reference person as stress-prone and thus potentially 
      unreliable might amplify self-experienced uncertainty and anxiety, which are 
      often associated with the prodromal phase. Such an enforcement of stress-related 
      processes could promote a conversion to psychosis.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Haidl, Theresa
AU  - Haidl T
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 
      62, 50934 Cologne, Germany.
FAU - Rosen, Marlene
AU  - Rosen M
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 
      62, 50934 Cologne, Germany.
FAU - Schultze-Lutter, Frauke
AU  - Schultze-Lutter F
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Effingerstrasse 14a, 3011 Bern, Switzerland; Department of 
      Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, 
      Bergische Landstrasse 2, 40629 Dusseldorf, Germany.
FAU - Nieman, Dorien
AU  - Nieman D
AD  - Department of Psychiatry, Academic Medical Center, University of Amsterdam, 
      Meibergdreef 5, 1105 AZ Amsterdam-Zuidoost, Netherlands.
FAU - Eggers, Susanne
AU  - Eggers S
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 
      62, 50934 Cologne, Germany.
FAU - Heinimaa, Markus
AU  - Heinimaa M
AD  - Department of Psychiatry, University of Turku, Kiinamyllynkatu 4-8, Rakennus 11B, 
      20520 Turku, Finland.
FAU - Juckel, Georg
AU  - Juckel G
AD  - Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University 
      Bochum, Alexandrinenstrasse 1, 344791 Bochum, Germany.
FAU - Heinz, Andreas
AU  - Heinz A
AD  - Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, 
      Charite, Campus Mitte, Chariteplatz 1, 10117 Berlin, Germany.
FAU - Morrison, Anthony
AU  - Morrison A
AD  - School of Psychological Sciences, University of Manchester, Oxford Rd, Manchester 
      M13 9PL, United Kingdom.
FAU - Linszen, Don
AU  - Linszen D
AD  - Department of Psychiatry, Academic Medical Center, University of Amsterdam, 
      Meibergdreef 5, 1105 AZ Amsterdam-Zuidoost, Netherlands; Department of Psychiatry 
      and Psychology, Maastricht University, PO Box 616, 6200 MD Maastricht, 
      Netherlands.
FAU - Salokangas, Raimo
AU  - Salokangas R
AD  - Department of Psychiatry, University of Turku, Kiinamyllynkatu 4-8, Rakennus 11B, 
      20520 Turku, Finland.
FAU - Klosterkotter, Joachim
AU  - Klosterkotter J
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 
      62, 50934 Cologne, Germany.
FAU - Birchwood, Max
AU  - Birchwood M
AD  - Mental Health and Wellbeing, Warwick Medical School, University of Warwick, 
      Coventry CV4 7AL, United Kingdom.
FAU - Patterson, Paul
AU  - Patterson P
AD  - Birmingham Children's Hospital, Steelhouse Ln, Birmingham B4 6NH, Birmingham, 
      United Kingdom.
FAU - Ruhrmann, Stephan
AU  - Ruhrmann S
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 
      62, 50934 Cologne, Germany. Electronic address: stephan.ruhrmann@uk-koeln.de.
CN  - European Prediction of Psychosis Study (EPOS) Group
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180413
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
MH  - *Expressed Emotion
MH  - Female
MH  - Humans
MH  - Male
MH  - Models, Psychological
MH  - Multivariate Analysis
MH  - Prodromal Symptoms
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Psychotic Disorders/*diagnosis/*psychology
MH  - Risk
MH  - Young Adult
OTO - NOTNLM
OT  - COGDIS
OT  - First Psychotic Episode (FEP)
OT  - Level of Expressed Emotions (LEE) Scale
OT  - Prediction
OT  - Ultra-high risk
EDAT- 2018/04/18 06:00
MHDA- 2019/03/12 06:00
CRDT- 2018/04/18 06:00
PHST- 2017/08/24 00:00 [received]
PHST- 2018/03/06 00:00 [revised]
PHST- 2018/03/12 00:00 [accepted]
PHST- 2018/04/18 06:00 [pubmed]
PHST- 2019/03/12 06:00 [medline]
PHST- 2018/04/18 06:00 [entrez]
AID - S0920-9964(18)30171-3 [pii]
AID - 10.1016/j.schres.2018.03.019 [doi]
PST - ppublish
SO  - Schizophr Res. 2018 Sep;199:346-352. doi: 10.1016/j.schres.2018.03.019. Epub 2018 
      Apr 13.