Family communication and involvement in people with psychosis: A mixed-methods study in Ethiopia

Abstract

Psychotic disorders have a significant impact on global health. Affecting over 24 million people worldwide, schizophrenia contributes substantially to the global burden of disease and is associated with high rates of disability and mortality. Comprehensive interventions targeting psychosocial factors have been proposed as effective strategies to improve the lives of people with psychosis. Expressed Emotion (EE) is a well-studied aspect of family dynamics that has been shown to predict relapse in Western settings. Consequently, this understanding has guided the development of family-based interventions, yielding improved outcomes. However, the applicability of EE in non-Western settings is limited for several reasons. Its framework tends to generalize emotional and behavioural expressions that are inherently culturally variable. Additionally, EE predominantly highlights negative family interactions, overlooking supportive ones. The focus is often skewed towards family attitudes and behaviours, with less attention given to the experiences of people with psychosis.