THE VALIDITY OF RELATIVES REPORTS

Because a valid psychiatric history is difficult to obtain from an acu te psychotic patient, particularly upon first admission, information g iven by important others is necessary for diagnostic classification, b ut the validity of this data must be examined. Within the ABC Schizoph renia Study, the onset and early course of schizophrenia was assessed from 171 post-psychotic first admissions and their close relatives. Hi gh agreement was found for substance abuse, self-destructive behaviour , paranoid delusion and social role deficits. Agreement was low for un specific symptoms like depression, anxiety, problems with concentratio n or sleep. Due to a lack of sensitivity of the relatives' reports, ag reement was also low for formal thought and perceptual disorders and d erealization. A second study with 30 patients with schizophrenia and w ith 2 or more relatives for each case (n = 69) demonstrated that the q uality of relatives' reports depends primarily on the relative's image of the patient (e. g., perceived dominance) and on the relative's att ributions about the cause of the disease. Close and long contact tends to impair the quality of reports. Again, the observation of different symptoms is influenced differently by these factors.