T233. CULTURAL CONSENSUS AND HIGH EXPRESSED EMOTION IN RELATIVES OF PEOPLE WITH SCHIZOPHRENIA AT THE MENTAL HEALTH INSTITUTE OF JALISCO, MEXICO
Authors: Audiffred Ricardo , de Alba García Javier Eduardo García 
Published: May 2020

Abstract

Background
Schizophrenia is a chronic mental disorder that affects almost 21 million people (WHO, 2017), in areas like: cognition, perception, language, behavior, and in its general functionality. Also generates complications in primary caregivers, whom in different studies have shown levels of emotional, physical and financial overload (De la higuera, 2005). This variables creates environments with High Expressed Emotionality (EE) in these families. EE is characterized by a series of relationships and communications in the family environment, loaded with negative assessments, criticism, control and over-involvement; such dynamics causes poor self-concept in individuals with psychosis, difficulty in adhering to treatment, negative emotional behaviors, symptomatic exacerbations and continuous relapses according to Rosenfarb, et al. (2000), Barrowclough, et al. (2003), and Sellwood, et al (2003).

Methods
This research had a Mixed method design, with an exploratory sequential strategy. The main objective of this study was to Identify the association between cultural consensus and expressed emotion in relatives of people with schizophrenia from the Mental Health Institute of Jalisco, México (SALME). The universe involved 40 relatives from 18 families of people diagnosed with schizophrenia, users of SALME. The sample was calculated based on Weller and Romney (1998) proporsal to obtain a level of proficiency higher than 50% for cognitive anthropology samples, with a confidence level of 95% and error of 5%. The EE was evaluated with the Seclén & Guanilo (1993) Familiar Expressed Emotionality Scale. The Cultural consensus was analized with Anthropac program for cultural domain analysis.

Results
66% of the families had high expressed emotion (EE) and 45% of the sample were cataloged with a high EE. A significant difference was found among relatives who had high EE and lower knowledge about schizophrenia vs relatives who had greater scientific knowledge and lower EE (t= -9.15, p=.00 /U. Mann-Witney= 1.00, p=.00). There was no evidence of a significant association between high EE and sociodemographic variables such as: sex, education, type of family member, occupation or religion. There was only a significant association between high EE and relatives living with the patient (x2 = 4.82, p≤.05) versus those relatives who only participated in day care.

Discussion
The sample of relatives contemplated for this study was similar to the number of families that have been included in other studies, for example: Jeff & Kuipers, et al (1982) or Guidorizzi, et al (2012). However, this design and research purposes were innovative in this area since there wasn′t found any reference from another study that addresses the issue of cultural consensus in schizophrenia, nor its relationship with high EE in relatives of people with this disorder. Conclusion: The less scientific knowledge about schizophrenia, the more expressed emotionality is shown.The importance of psychoeducation is highlighted to promote scientific knowledge of mental illnesses in order to reduce high EE.