Comments on the article by Okasha et al (see PA, Vol 81:45335), which reported a replication of the link between expressed emotion and relapse in depressed patients in Egypt. The level of family criticism that best predicted relapse in unipolar and bipolar outpatients after 9 mo was 7 critical comments. Okasha et al attributed this cutoff, higher than levels of criticism associated with relapse in Western studies, to cultural factors. The authors discuss several issues which render this conclusion premature.