Predictors of expressed emotion among the caregivers of patients with severe mental illnesses attending a tertiary health facility in Kano


  • Aghukwa NC Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, Nigeria
  • Baguda AS Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, Nigeria
  • Fawaz B Department of Psychiatry, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
  • Aminu IS Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, Nigeria



Expressed Emotion, Caregivers, Mental Illness, Predictors


Background: Expressed Emotion (EE) measures the emotional climate between caregivers and patients with major mental disorders. High EE could trigger relapses in schizophrenia and other conditions. However, the factors influencing high EE were poorly understood, especially in Africa. This study explored the socio-demographic, personality, and patient-related predictors of high EE among caregivers in Kano.

Objectives: The study aimed to estimate the prevalence of high EE and its associations with socio-demographic factors, personality traits, and patients’ illness characteristics.

Methods: The study utilized a descriptive cross-sectional design, encompassing 270 patients diagnosed with schizophrenia or bipolar disorder, each accompanied by their corresponding caregiver, totalling 270 caregivers. All participants attended the psychiatric clinic at Aminu Kano Teaching Hospital. The data collection process involved questionnaires and interviews, addressing socio-demographics, illness characteristics, personality traits, and expressed emotion (EE).

Results: We analyzed the socio-demographic factors and EE of 250 patients and their corresponding 250 caregivers. High EE was prevalent (42.8%) due to critical comments and emotional over-involvement. Caregivers scored high on all personality traits, but only neuroticism correlated positively with EE (r = 0.130, p < 0.05). EE was lower for bipolar disorder than for schizophrenia (r = -.126, p < .05). EE also increased with patient symptoms, caregiver burden, and relapse frequency.

Conclusion: Caregivers of patients with schizophrenia and bipolar disorder in Kano showed high expressed emotion (EE). However, none of the analyzed factors, including socio-demographic and personality traits, emerged as significant predictors of EE. Further research is needed to improve interventions and support strategies for caregivers of individuals with severe mental illnesses.