Background: Little is known about quality of life among schizophrenic patients. The roles of caregiver expressed emotion and medication adherence on the QoL of schizophrenic patients have not been well-researched. The study was designed to determine the prevalence of caregiver high EE (HEE), as well as the relationship between caregiver EE, QoL and medication adherence among schizophrenic patients in Kano, Nigeria.

Methodology: A descriptive cross-sectional study was conducted among schizophrenic patients and their caregivers attending a psychiatric clinic in Nigeria, with a response rate of 92.6%.           MINI-7 and PANSS scale were respectively used to confirm lifetime schizophrenia and remission criteria among the patient respondents. Relative version of the Level of Expressed Emotion Scale and World Health Organization Quality of Life Bref scale were used to determine the level of EE among the caregivers and to assess the QoL among the patient respondents respectively. Morisky Medication Adherence Scale was used to assess for level of adherence to medication.

Results: Prevalence of caregiver HEE was 52%. Only 18.4% and 39.2% of the patient respondents enjoyed “good” overall QoL and were treatment adherent respectively.  Caregiver EE was significantly associated with the physical and environmental domains of QoL (p=0.011 and p=0.001 respectively). Poor medication adherence correlated positively with the negative attitude and low tolerance sub-scales of the level of EE scale (p=0.019 and p<0.001). Medication adherence related significantly to the overall, health-related and physical domains of QoL (p<0.001, p=0.017 and p=0.031). Medication adherence was also a positive predictor of overall QoL (p<0.001).

Conclusion: HEE was common among the caregivers of schizophrenic patients in this study. The HEE has been found to be closely related to the patients’ QoL. The role of medication adherence in promoting QoL among schizophrenic patients has been re-emphasized by the findings of this study.