BACKGROUND We examined whether expressed emotion (EE) influenced the course of schizophrenia in Japan.

METHOD We conducted a cohort study. Of 73 subjects with schizophrenia meeting the diagnostic criteria of ICD-9 or DSM-III-R, 52 participated in the study. The Camberwell Family Interview was conducted to evaluate EE. The subjects had been followed up for nine months and psychiatrists who were blind to the EE status evaluated their symptoms with the Brief Psychiatric Rating Scale.

RESULTS The relapse rate in the high-EE group was 58% and that in the low-EE group 21% (P < 0.01). Nine-month relapse risk ratio was 2.72 (95% CI 1.24 to 5.97). CONCLUSION. In Japan, as elsewhere, EE is a good predictor of schizophrenic relapse.