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Factors influencing the validity of relatives' reports about symptoms of first-episode schizophrenia

Published online by Cambridge University Press:  16 April 2020

M Hambrecht
M Hambrecht*
Affiliation:
Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität zu Köln, D-50924Köln, Germany
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Summary

Valid information on the early course of schizophrenia is necessary for clinical and research purposes, for example, to determine the onset of the disorder. Since reports given by psychotic patients are questionable, relatives are often asked about their observations. In order to test the quality of these reports, the recollections of emerging symptomatology were assessed systematically from 30 recent onset, postpsychotic schizophrenic patients and from 69 informants (mostly their close relatives) by means of the Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS). Patient-informant agreement rates like kappa were compared between the relatives of every single case. Multiple regression analyses demonstrated that personality and attributional factors, particularly causal attributions and the image the informant has about him/herself and about the patient, determine the quality of the informants' reports. Highest kappas over all symptoms, for instance, were reached by relatives who described the patient as “dominant” and themselves as “reserved”, and who attributed the disease to current psychosocial stress. Long and close contact to the patient tends to impair the quality of reports.

Keywords

familyhistoryvalidityschizophrenia
Type
Original articles
Information
European Psychiatry , Volume 12 , Issue 7 , 1997 , pp. 345 - 351
Copyright
Copyright © Elsevier, Paris 1997

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Footnotes

*

Presented in part at the AEP - Section of Epidemiology and Community Psychiatry Conference “The role of epidemiology in psychiatry: current perspectives and future trends”, Cambridge, 11–13 April 1996.

References

Amador, XF, Strauss, DH, Yale, SA, Gorman, JM. Awareness of illness in schizophrenia. Schizophr Bull 1991; 17: 113–132CrossRefGoogle Scholar
Andreasen, NC. The scale for the assessment of negative symptoms (SANS) conceptual and theoretical foundations. Br J Psychiatry 1989; 155: 49–52 (Suppl 7)CrossRefGoogle Scholar
Andreasen, NC, Flaum, M, Arndt, S. The comprehensive assessment of symptoms and history (CASH). An instrument for assessing diagnosis and psychopathology. Arch Gen Psychiatry 1992; 49: 615–623CrossRefGoogle ScholarPubMed
Angermeyer, MC, Klussmann, D, Walpuski, O. The causes of functional psychoses as seen by patients and their relatives. II. The relatives' point of view. Eur Arch Psychiatry Clin Neurosci 1988; 238: 55–61CrossRefGoogle ScholarPubMed
Asai, K.. Schizophrenic patients and the families in Japan. Int J Family Psychiatry 1987; 8: 1–7Google Scholar
Barrowclough, C, Tarrier, N, Watts, S, Vaughn, C, Bamrah, JS, Freeman, HL. Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report. Br J Psychiatry 1987; 151: 1–8CrossRefGoogle ScholarPubMed
Beckmann, D, Richter, HEGießen-Test (GT) Bern: Hans Huber, 1972Google Scholar
Birchwood, M, Smith, J, MacMillan, F, Hogg, B, Prasad, R, Harvey, Cet al. Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation. Psychol Med 1989; 19: 649–656CrossRefGoogle ScholarPubMed
Brewin, CR, MacCarthy, B, Duda, K, Vaughn, CE. Attribution and expressed emotion in the relatives of patients with schizophrenia. J Abnorm Psychol 1991; 100: 546–554CrossRefGoogle ScholarPubMed
Buchkremer, G, Rath, NTherapeutische Arbeit mit Angehörigen schizophrener Patienten, Meßinstrumente, Methoden, Konzepte Bern: Hans Huber, 1989Google Scholar
Cicchetti, DV, Feinstein, AR. High agreement but low Kappa. II. Resolving the paradoxes. J Clin Epidemiol 1990; 43: 551–558CrossRefGoogle ScholarPubMed
Cohen, J. A coefficient of agreement for nominal scales. Educ Psychol Measurem 1960; 20: 37–46CrossRefGoogle Scholar
Conrad, KDie beginnende Schizophrenie, Versuch einer Gestaltanalyse des Wahns Stuttgart, New York: Thieme, 1958Google Scholar
Feinstein, AR, Cicchetti, DV. High agreement but low Kappa. I. The problems of two paradoxes. J Clin Epidemiol 1990; 43: 543–549CrossRefGoogle ScholarPubMed
Gaebel, W, Frick, U, Kopcke, W, Linden, M, Müller, P, Müller-Spahn, Fet al. Early neuroleptic intervention in schizophrenia: are prodromal symptoms valid predictors of relapse?. Br J Psychiatry 1993 8–12 (Suppl 21)CrossRefGoogle Scholar
Goldstein, JM, Kreisman, D. Gender, family environment and schizophrenia. Psychol Med 1988; 18: 861–872CrossRefGoogle Scholar
Häfner, H, Riecher-Rössler, A, Maurer, K, Fätkenheuer, B, Löffler, W. First onset and early symptomatology of schizophrenia. A chapter of epidemiological and neurobiological research into age and sex differences. Eur Arch Psychiatry Clin Neurosci 1992; 242: 109–118CrossRefGoogle ScholarPubMed
Häfner, H, Riecher-Rössler, A, Hambrecht, M, Maurer, K, Meissner, S, Schmidtke, Aet al. IRAOS: an instrument for the retrospective assessment of the onset of schizophrenia. Schizophr Res 1992; 6: 209–223CrossRefGoogle Scholar
Häfner, H, Maurer, K, Löffler, W, Riecher-Rössler, A. The influence of age and sex on the onset and early course of schizophrenia. Br J Psychiatry 1993; 162: 80–86CrossRefGoogle ScholarPubMed
Häfner, H, Maurer, K. The methodology of first onset assessment by the example of schizophrenia. Schizophr Res 1995; 15: 265–276Google Scholar
Hambrecht, M. A second case of schizophrenia in the family: Is it observed differently?. Eur Arch Psychiatry Clin Neurosci 1995; 245: 267–269CrossRefGoogle ScholarPubMed
Hambrecht, M, Häfner, H, Löffler, W. Beginning schizophrenia observed by significant others. Soc Psychiatry Psychiatr Epidemiol 1994; 29: 59–64Google ScholarPubMed
Hambrecht, M, Häfner, H. Sensitivity and specificity of relatives' reports on the early course of schizophrenia. Psychopathology 1997; 30: 12–19CrossRefGoogle ScholarPubMed
Herz, MI, Melville, C. Relapse in schizophrenia. Am J Psychiatry 1980; 137: 801–805Google Scholar
Herz, MI, Lamberti, JS. Prodromal symptoms and relapse prevention in schizophrenia. Schizophr Bull 1995; 21: 541–551CrossRefGoogle Scholar
Jackson, HJ, McGorry, PD, McKenzie, D. The reliability of DSM-III prodromal symptoms in first episode psychotic patients. Acta Psychiatr Scand 1994; 90: 375–378CrossRefGoogle ScholarPubMed
Jones, EE, Nisbett, REThe actor and the observer: divergent perceptions of the causes of behavior In: Jones, EEet al, eds. Attribution: Perceiving the Causes of Behavior Morristown: General Learning Press, 1972Google Scholar
Klug, J, an der Heiden, W, Jakubaschk, J. Der Einfluß der Kategorisierungswahl auf die Inter-Rater-Reliabilität des “Present State Examination”. Diagnostica 1979; 25: 59–68Google Scholar
Kreisman, D, Simmens, S, Joy, V. Rejecting the patient: preliminary validation of a self-report scale. Schizophr Bull 1979; 5: 220–222CrossRefGoogle ScholarPubMed
Leff, J, Vaughn, CEExpressed Emotion in Families London: Guilford Press, 1985Google Scholar
Lehrl, SMehrfachwahl-Wortschatz-Intelligenztest MWT-B, Manual. 2 Aufl Erlangen: perimed-Fachbuch-Verlag, 1989neubearbGoogle Scholar
Lewis, V, Zeichner, A. Impact of admission to a mental hospital on the patient's family. Ment Hygiene 1960; 44: 503–509Google ScholarPubMed
Linn, MW. Of wedding bells and apron strings. A study of relatives' attitudes. Ment Hygiene 1966; 50: 100–103Google ScholarPubMed
Mayer-Gross, W. Über die Stellungnahme zur abgelaufenen akuten Psychose. Zeitschrift für die Gesamte Neurologie und Psychiatrie 1920; 60: 160–212CrossRefGoogle Scholar
Mintz, LI, Nuechterlein, KH, Goldstein, MJ, Mintz, J, Snyder, KS. The initial onset of schizophrenia and family expressed emotion. Some methodological considerations. Br J Psychiatry 1989; 154: 212–217CrossRefGoogle ScholarPubMed
Norman, RMG, Malla, AK. Prodromal symptoms of relapse in schizophrenia: a review. Schizophr Bull 1995; 21: 527–539CrossRefGoogle ScholarPubMed
Ohta, Y, Nakane, Y. Features of schizophrenic patients and patients with depression as observed by family members - symptoms, social activities, and social performance. Jpn J Psychiatr Neurol 1989; 43: 29–36Google ScholarPubMed
Olbrich, R, Watzl, H. Discussion topics (response patterns) in groups for relatives of schizophrenics. Int J Family Psychiatry 1987; 8: 201–210Google Scholar
Perlick, D, Stastny, P, Mattis, S, Teresi, J. Contribution of family, cognitive and clinical dimensions to long-term outcome in schizophrenia. Schizophr Res 1992; 6: 257–265CrossRefGoogle Scholar
Rist, F, Watzl, H. Emotionale Reaktionen Angehöriger auf schizophrene Erkrankungen: Itemanalyse und Validierung der “Patient Rejection Scale”. Z Klin Psychol 1989; 18: 134–143Google Scholar
Weissman, MM, Wickramaratne, P, Warner, V, John, K, Prusoff, BA, Merikangas, KRet al. Assessing psychiatric disorders in children. Discrepancies between mothers' and children's reports. Arch Gen Psychiatry 1987; 44: 747–753CrossRefGoogle ScholarPubMed
Wing, JK, Cooper, JE, Sartorius, NMeasurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Program London: Cambridge University Press, 1974Google Scholar
WHO World Health Organization Psychiatric Disability Assessment Schedule (WHO/DAS) Geneva: WHO, 1988Google Scholar
Yarrow, M, Schwartz, C, Murphy, H, Deasy, L. The psychological meaning of mental illness in the family. J Social Issues 1955; 11: 12–24CrossRefGoogle Scholar
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