Epilepsy in childhood may alter family relationships but the relevance of these changes for
the increased rates of psychopathology has been little investigated. This study uses maternal
expressed emotion (EE) to examine family relationships of children with epilepsy and the
association with high risk for psychiatric disorder. EE was assessed using the Camberwell
Family Interview carried out with the mothers of 22 schoolchildren with chronic epilepsy
who were attending a general hospital outpatient clinic. Sixteen of these children had
similarly aged healthy siblings who served as controls. High risk for psychiatric disorder in
the children and mothers was assessed using behavioural, mood, and self-esteem questionnaires
completed by mothers, teachers, and children. It was found that mothers showed
significantly more emotional overinvolvement and a trend for more hostility towards their
children with epilepsy than towards sibling controls. For the 22 children with epilepsy,
maternal emotional overinvolvement was not associated with child behavioural deviance.
High levels of criticism and, to a lesser extent, hostility did show associations with child
behavioural deviance, and the strongest links were between maternal criticism and maternal
rated antisocial and overactive behaviour in the child. Fewer positive comments by mothers
towards the children were associated with child emotional symptoms and lower self-esteem
in a number of areas. This study suggests that further research could consider the
appropriateness of psychological intervention for families in which mothers are critical and
hostile and whose children show antisocial behaviour.