Expressed emotion (EE) in key relatives of 21 patients with bipolar affective or schizoaffective psychoses was assessed by the CFI. All patients had been on prophylactic lithium for at least three years and were without psychotic symptoms at interview. The relationship between relatives' EE status and patients' course of illness was studied both retrospectively and prospectively. Two critical remarks designated high EE. The relatives' EE status was not related to number of hospital admissions or to severity and length of recurrences if the entire period of lithium treatment is considered as a whole. However, patients living with high-EE relatives showed a significantly poorer response during the three years before interview, and an even poorer response in the nine-month follow-up.