Research Article
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Abstract
Background and Purpose: The Family Questionnaire-Brazilian Portuguese Version (FQ-BPV) has been preliminarily validated in the Brazilian population. This study assessed the predictive validity of the FQ-BPV for relapse in patients with schizophrenia. Methods: Ninety-four dyads (patients with schizophrenia and their relatives) were recruited from three mental health clinics. Expressed emotion was assessed using the FQ-BPV. Presence of relapse was assessed at 6-, 9-, 12-, and 18-month follow-ups and analyzed through logistic regressions. Results: The critical comments (CC) domain of the FQ-BPV was statistically significant at 18 months. However, the model was not sufficiently robust to classify individuals correctly into relapse or no relapse categories. Conclusion: The FQ-BPV did not predict relapse well and we cannot recommend it for that purpose in Brazil without further studies.
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Tables
TABLE 1.
Characteristics of 92 Dyads (Patients With Schizophrenia and Family Relatives)
| Personal Characteristics | Patient With Schizophrenia | Relative |
|---|---|---|
| Age in years, M (SD) | 46.8 (13.8) | 55.7 (16.2) |
| Mdn (min, max) | 47.5 (18, 77) | 57.0 (18, 89) |
| Gender, % (n) females | 41.3 (38) | 71.7 (66) |
| Education level, % (n) with HS or more | 26.0 (24) | 30.5 (28) |
| Working status, % (n) not workinga | 89.1 (82) | — |
| Marital status, % (n) with partnerb | — | 56.5 (52) |
| Relationship to patient, % (n) | ||
| Mother | 29.3 (27) | |
| Brother or sister | 29.3 (27) | |
| Spouse | 17.4 (16) | |
| Son or daughter | 12.0 (11) | |
| Father | 6.5 (6) | |
| Other | 5.4 (5) | |
| Time spent with patient in hours per day, M (SD) | 15.5 (9.1) | |
| Mdn (min, max) | 22 (1, 24) | |
| Clinical Characteristics | |
|---|---|
| Duration of condition in years, M (SD) | 18.4 (12.0) |
| Mdn (min, max) | 15.0 (1, 50) |
| Number of hospitalizations in past 2 years, % (n) | |
| None | 71.7 (66) |
| 1–2 | 14.2 (13) |
| 3–9 | 7.6 (7) |
| More than 10 | 6.6 (6) |
| Psychiatric relapse after enrollment in study, % (n) | |
| At end of 6 months | 13.0 (12) |
| At end of 9 monthsb | 15.4 (14) |
| At end of 12 monthsb | 16.5 (15) |
| At end of 18 monthsb | 20.9 (19) |
Note. min = minimum; max = maximum; HS = high school (12 years in Brazil).
[i] aFour missing values.
[ii] bOne missing value.
TABLE 2.
Expressed Emotion Measured by the Family Questionnaire-Brazilian Portuguese Version at Baseline
| Expressed Emotions | M (SD) | Mdn (Min, Max) | % (n) |
|---|---|---|---|
| Scores for domains | |||
| Emotional overinvolvement (EOI) | 27.8 (5.8) | 29.0 (15, 40) | |
| Critical comments (CC) | 22.7 (7.5) | 22.5 (10, 40) | |
| Proportion of elevated expressed emotions | |||
| High level of EOI (>29), % (n) | 52.2 (48) | ||
| High level of CC (>23), % (n) | 50.0 (46) | ||
| High level of expressed emotionsa | 69.6 (64) | ||
Note. Min = minimum; Max = maximum.
[i] aEither EOI > 29, or CC > 23, or both.
TABLE 3.
Pearson Correlations Among the Numeric Explanatory Variables to Be Used in the Logistic Regression
| Duration of Condition | Emotional Overinvolvement | Critical Comments | |
|---|---|---|---|
| Age of patient with schizophrenia | .64 | −.19 | −.18 |
| Duration of condition | −.01 | −.08 | |
| Emotional overinvolvement | .46 |
Note. Boldface values represent correlations statistically different from zero at .01 significance level.
TABLE 4.
Logistic Regression Analysis for Predictive Validity of the Relapse: Models for Different Time Frames and Variables
| Relapse At | No. of Relapses/Total | Age | Gender | Duration of Condition | CC Score | EOI Score | EE Indicator |
|---|---|---|---|---|---|---|---|
| 6 months | |||||||
| Model 1 | 12/91 | .045 | NE | NE | — | — | — |
| Model 2 | 12/92 | .057 | — | — | NE | NE | — |
| Model 3 | 12/92 | .057 | — | — | — | — | NE |
| 9 months | |||||||
| Model 1 | 13/90 | .023 | NE | NE | — | — | — |
| Model 2 | 14/91 | .009 | — | — | NE | NE | — |
| Model 3 | 14/91 | .009 | — | — | — | — | NE |
| 12 months | |||||||
| Model 1 | 14/90 | .044 | NE | NE | — | — | — |
| Model 2 | 15/91 | .018 | — | — | NE | NE | — |
| Model 3 | 15/91 | .018 | — | — | — | — | NE |
| 18 months | |||||||
| Model 1 | 18/90 | NE | NE | NE | — | — | — |
| Model 2 | 18/89 | — | — | — | .008 | NE | — |
| Model 3 | 19/91 | — | — | — | — | — | NE |
Note. Cells show p values for variables. CC = critical comment; EOI = emotional overinvolvement; EE = expressed emotions; NE = not entered in forward method at a level 0.05; — = not considered in the model construction; Model 1 = only age, gender, and duration of condition (forward); Model 2 = variables from Model 1 that were statistically significant plus EOI and CC (forward); Model 3 = variables from Model 1 that were statistically significant plus EE (forward).
Article usage
| Period | Abstract | Full | Total | |
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| Dec 2021 | 5 | 19 | 4 | 28 |
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| Jul 2021 | 5 | 2 | 4 | 11 |
| Jun 2021 | 2 | 7 | 3 | 12 |
| May 2021 | 1 | 9 | 3 | 13 |
| Apr 2021 | 19 | 9 | 3 | 31 |
| Mar 2021 | 7 | 8 | 1 | 16 |
| Feb 2021 | 6 | 5 | 1 | 12 |
| Jan 2021 | 4 | 8 | 3 | 15 |
| Dec 2020 | 2 | 6 | 3 | 11 |
| Nov 2020 | 11 | 8 | 2 | 21 |
| Oct 2020 | 11 | 4 | 2 | 17 |
| Sep 2020 | 4 | 7 | 3 | 14 |
| Aug 2020 | 12 | 0 | 0 | 12 |
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| Apr 2020 | 10 | 2 | 1 | 13 |
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| Feb 2020 | 6 | 10 | 1 | 17 |
| Jan 2020 | 83 | 13 | 1 | 97 |
| Dec 2019 | 486 | 9 | 2 | 497 |
| Nov 2019 | 3 | 19 | 3 | 25 |
| Oct 2019 | 0 | 8 | 2 | 10 |
| Sep 2019 | 0 | 9 | 6 | 15 |
| Aug 2019 | 0 | 2 | 3 | 5 |
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| Jun 2019 | 2 | 14 | 10 | 26 |
| May 2019 | 0 | 10 | 4 | 14 |
| Apr 2019 | 14 | 0 | 0 | 14 |
| Mar 2019 | 36 | 0 | 0 | 36 |
| Feb 2019 | 27 | 0 | 0 | 27 |
| Jan 2019 | 15 | 0 | 0 | 15 |
| Dec 2018 | 19 | 0 | 0 | 19 |
| Nov 2018 | 6 | 0 | 1 | 7 |
| Oct 2018 | 18 | 2 | 1 | 21 |
| Sep 2018 | 22 | 0 | 0 | 22 |
| Aug 2018 | 4 | 0 | 0 | 4 |
| Jul 2018 | 5 | 0 | 0 | 5 |
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