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Abstract
Background: Expressed emotion refers to the attitudes, feelings, and behavioral responses
exhibited by family caregivers toward individuals living with schizophrenia. Expressed
emotion typically manifests through frequent criticism, hostility, or emotional over-
involvement from family members, which can increase psychological stress, exacerbate
symptoms, and impair emotional regulation.
Objectives: The aim of this study is to assess the prevalence and associated factors of high
expressed emotion among caregivers of people with severe mental illness who attends
psychiatric service unit of specialized hospitals found in Bahir Dar city, in 2025/2026.
Method: Hospital based cross sectional study, with sample size of 419 was be conducted
from January to February,2026 using proportional sampling from the 2 comprehnsive
spesialized hospitals and systematic sampling was be used in each hospital. Family
questionnaire was used to assess the prevalence of expressed emotion. Data were collected by
electronics kobo tool software and exported to STATA version 14 for analysis. Binary
logistic regression and multivariable logistic regression analysis were used to identify factors
associated with high expressed emotion. Model fitness was checked using Hosmer-
Lemeshow goodness of fit test. Adjusted odds ratio at 95% confidence interval and p-values
< 0.05 were used to declare significant association.
Result: This study found that the overall prevalence of high expressed emotion was 39.86%
with (95%CI:35.15, 44.56). This study revealed that social support (AOR= 3.67; 95%CI:
1.56, 8.63), severity of illness, perceived burden (AOR= 5.61; 95%CI:2.63, 11.98), perceived
stigma (AOR: 2.16; 95%CI:1.14, 4.11), poor medication adherence (AOR= 3.69;
95%CI:1.35, 8.72), schizophrenia (AOR= 2.17; 95%CI:1.05, 4.47), and daily caregiving
hours (AOR= 3.20; 95%CI:1.38, 7.42) were factors significantly associated with high
expressed emotion.
Conclusion: This study found that the prevalence of high expressed emotion among
caregivers of people living with severe mental illness was high. High expressed emotion was significantly associated with poor social support, severity of patient illness, perceived
caregiving burden, perceived stigma, patient medication non-adherence, and prolonged daily caregiving hours. |
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