Expressed emotion and associated factors among primary caregivers of people with schizophrenia in public hospitals Eastern Ethiopia

Expressed emotion is an attitude, feeling, and emotional reaction of primary caregivers toward people with schizophrenia. High levels of expressed emotion in primary caregivers are linked to a higher relapse rate in those with schizophrenia than in families with low levels of expressed emotion. Despite the critical role of caregivers in the management of schizophrenia, there is limited research on their expressed emotions in eastern Ethiopia. To assess expressed emotions and associated factors among primary caregivers of people with schizophrenia receiving treatment at public hospitals in Harari Regional State and Dire Dawa Administrative City from June 1 to June 30, 2024. A hospital-based, cross-sectional study was conducted among 414 participants at public hospitals in Harari Regional State and Dire Dawa city Administrative. A systematic sampling method was used to select study participants. The expressed emotions were assessed via family questionnaires. Data entry and analysis were performed via Epi-Data 4.6 and STATA version 14, respectively. Bivariable and multivariable logistic regression were used to evaluate the associations between independent and outcome variables. Variables with p values < 0.05 were considered statistically significant, and adjusted odds ratios and 95% confidence intervals were used to determine the strength of the associations. The prevalence of highly expressed emotions in this study was 48.31% (95% CI 43.51-53.14%). A duration of caregiving of more than 8 years (AOR 2.74; 95% CI 1.02, 7.33), severity of illness (AOR 3.45; 95% CI 1.89; 6.28), severe burden (AOR 4.34; 95% CI 2.03, 9.28), perceived stigma (AOR 2.59; 95% CI 1.53, 4.41), and poor social support (AOR 3.54; 95% CI 1.74, 7.19) were significantly associated with highly expressed emotion. This study revealed that the prevalence of expressed emotion is significantly high. The duration of caregiving; perceived stigma, burden, and severity of illness; and social support of the study participants were significantly associated with expressed emotion. Promote policies that ensure better coordination of care between mental health professionals, primary care providers, and social services to create a more comprehensive care plan.