Partners' expressed emotion and the control and management of Type 1 diabetes in adults

Objective: "Expressed emotion" (EE) refers to a set of valid and reliable measures of family emotional attitudes, which are robust predictors of illness course in several psychiatric conditions and which have recently been studied in some medical conditions. We hypothesised that high EE in partners of diabetes patients would be associated with poorer glucose control, management of and adaptation to diabetes. Methods: Sixty adult Type 1 diabetes patients, who were attending routine clinics at a specialist diabetes centre, and their partners were interviewed separately and completed various questionnaire measures. Partners' EE was rated from a modified Camberwell Family Interview; patients were interviewed to assess self-management practices. Glycated hemoglobin (HbA(1c)) was the measure of glucose control. Results: Only 10/60 (17%) partners were classified as high EE. Patients with high-EE partners had significantly worse self-management scores, more negative appraisal of diabetes, and higher depression scores than those with low-EE partners, but there was no association between EE measures and HbA(1c),. Conclusions: In contrast to findings from previous research on the families of patients with psychiatric illnesses, only a minority of partners of adult patients with Type 1 diabetes are classified as high-EE. We found no evidence that partners' EE was related to patients' blood glucose control. (C) 2000 Elsevier Science Inc. All rights reserved.