Expressed emotion of caregivers to children at familial high risk of schizophrenia or bipolar disorder: The Danish High Risk and Resilience Study – <scp>VIA</scp> 11

A high level of parental expressed emotion is thought to play an important role in the development and course of mental disorders in offspring. This study investigates expressed emotion among primary caregivers to 11-year-old children at familial high risk of schizophrenia or bipolar disorder and population-based controls, and whether potential differences in expressed emotion are related to child psychopathology. Expressed emotion was assessed with the Five-Minute Speech Sample and a total of 440 audio files from primary caregivers were collected. Child psychopathology was assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children. Primary caregivers from families with a parental diagnosis of schizophrenia spectrum disorder or bipolar disorder were classified as high on expressed emotion significantly more often than population-based controls. Between-group differences remained significant after adjusting for any current axis I child diagnosis indicating that high expressed emotion is not solely attributable to the presence of child psychopathology. These findings underline the importance of assessing the emotional climate in families with parental schizophrenia and bipolar disorder.