The relationship between expressed emotion and treatment resistance in patients with major depression

Aim: Expressed emotion (EE) is associated with relapse in major depression.However, past research on its relationship with treatment resistance is limited.In this study, we aimed to investigate whether there is any difference in terms of EE between treatment-resistant depression (TRD) and non-resistant depression (non-TRD) patients, and the relationship between the clinical characteristics of depression and EE.Material and Methods: The study included 50 patients with TRD, 50 patients with non-TRD and the relatives of these 100 patients.All patients were given the Quick Inventory of Depressive Symptomatology Self-Report Form (QIDS_SR16) and Level of Expressed Emotion (LEE) Scale.Furthermore, the Expressed Emotion (EE) Scale was applied to the relatives of the patients to determine the level of EE.Results: LEE total score (p = 0.020) and EE total score (p <0.001) were found to be significantly higher in the TRD group.There was a positive correlation between the QIDS-SR16 total score and total EE and LEE scores and all subscale scores (p <0.05).Regression analysis revealed that the QIDS total score (0.394) and male gender (0.219) were associated with the total score of EE.The LEE total score was predicted by QIDS total score (0.370), and the higher education level of the close relative (0.219).Discussion: Besides its limitations, the present study is the first study comparing the expressed emotion between TRD and non-resistant major depression patients.Prospective studies with a large sample size are needed regarding how expressed emotion affects the severity of the disease and its clinical course.