{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:55:51Z","timestamp":1781830551549,"version":"3.54.5"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Indian Journal of Psychological Medicine"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Caregivers of patients with bipolar disorder (BD) undergo a considerable amount of burden. In India, family caregivers are the primary source of support and care for their ill relatives. The burden faced by family members of patients with BD often results in physical and mental health consequences. This may lead to negative interaction patterns such as hostility, criticality, and overinvolvement, termed as expressed emotions (EE). Here, we report how we addressed the EE in family members, using a single-subject design that involved the family caregivers (n = 2) of two adults who presented with a diagnosis of BD with a current episode of mania. An assessment of family caregivers, using the family questionnaire, revealed high EE. Family focused therapy (FFT) of 12 sessions was delivered over 3\u20134 weeks on an inpatient basis, with positive outcomes of reductions in EE and family stress and improved psychosocial functioning in patient that were sustained over 9\u201310 months. FFT can be an important add on psychosocial therapy to reduce EE and stress and to facilitate functioning and communication.<\/jats:p>","DOI":"10.1177\/0253717620950253","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T08:10:51Z","timestamp":1600330251000},"page":"261-264","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Family Focused Therapy for Family Members of Patients with Bipolar Disorder: Case Reports of Its Impact on Expressed Emotions"],"prefix":"10.1177","volume":"43","author":[{"given":"N.","family":"Padmavathi","sequence":"first","affiliation":[{"name":"Dept. of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sailaxmi","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Dept. of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Manjula M","sequence":"additional","affiliation":[{"name":"Dept. of Clinical Psychology, NIMHANS, Bengaluru, Karnataka, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biju","family":"Viswanath","sequence":"additional","affiliation":[{"name":"Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Jain","sequence":"additional","affiliation":[{"name":"Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"bibr1-0253717620950253","doi-asserted-by":"crossref","unstructured":"Depp CA, Davis CE, Mittal D . Health-related quality of life and functioning of middle-aged and elderly adults with bipolar disorder. J Clin Psychiatry 2006; 67(2): 215\u2013221.","DOI":"10.4088\/JCP.v67n0207"},{"key":"bibr2-0253717620950253","doi-asserted-by":"crossref","unstructured":"Goossens PJJ, Van Wijngaarden B, Knoppert-Van Der Klein EAM . Family caregiving in bipolar disorder: caregiver consequences, caregiver coping styles, and caregiver distress. Int J Soc Psychiatry 2008; 54(4): 303\u2013316.","DOI":"10.1177\/0020764008090284"},{"key":"bibr3-0253717620950253","doi-asserted-by":"crossref","unstructured":"Ostacher MJ, Nierenberg AA, Iosifescu DV . Correlates of subjective and objective burden among caregivers of patients with bipolar disorder. Acta Psychiatr Scand 2008; 118(1): 49\u201356.","DOI":"10.1111\/j.1600-0447.2008.01201.x"},{"key":"bibr4-0253717620950253","doi-asserted-by":"crossref","unstructured":"Roth GA, Abate D, Abate KH . Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392(10159): 1736\u20131788.","DOI":"10.1016\/S0140-6736(18)32203-7"},{"key":"bibr5-0253717620950253","doi-asserted-by":"crossref","unstructured":"Chadda RK. Caring for the family caregivers of persons with mental illness. Indian J Psychiatry 2014; 56(3): 221.","DOI":"10.4103\/0019-5545.140616"},{"key":"bibr6-0253717620950253","doi-asserted-by":"crossref","unstructured":"Sadath A, Muralidhar D, Varambally S . Caregiving and help seeking in first episode psychosis: a qualitative study. J Psychosoc Rehabil Ment Health 2014; 1(2): 47\u201353.","DOI":"10.1007\/s40737-014-0013-2"},{"key":"bibr7-0253717620950253","doi-asserted-by":"crossref","unstructured":"Chakrabarti S. 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Burden, reward and family functioning of caregivers for relatives with mood disorders: 1-year follow-up. J Affect Disord 2004 December; 83(2\u20133): 221.","DOI":"10.1016\/j.jad.2004.04.013"},{"key":"bibr12-0253717620950253","doi-asserted-by":"crossref","unstructured":"Miklowitz DJ. The role of family systems in severe and recurrent psychiatric disorders: a developmental psychopathology view. Dev Psychopathol 2004 September; 16(3): 667\u2013688.","DOI":"10.1017\/S0954579404004729"},{"key":"bibr13-0253717620950253","doi-asserted-by":"crossref","unstructured":"Miklowitz DJ, Chung B. Family-focused therapy for bipolar disorder: reflections on 30 years of research. Family Process 2016 September; 55(3): 483-499.","DOI":"10.1111\/famp.12237"},{"key":"bibr14-0253717620950253","doi-asserted-by":"crossref","unstructured":"Wiedemann G, Rayki O, Feinstein E . The family questionnaire: development and validation of a new self-report scale for assessing expressed emotion. 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