Die Verläßlichkeit von Angehörigenangaben zur Krankheitsanamnese Schizophrener

: Because a valid psychiatric history is difficult to obtain from an acute psychotic patient, particularly upon first admission, information given by important others is necessary for diagnostic classification, but the validity of this data must be examined. Within the ABC Schizophrenia Study, the onset and early course of schizophrenia was assessed from 171 post-psychotic first admissions and their close relatives. High agreement was found for substance abuse, self-destructive behaviour, paranoid delusion and social role deficits. Agreement was low for unspecific symptoms like depression, anxiety, problems with concentration or sleep. Due to a lack of sensitivity of the relatives' reports, agreement was also low for formal thought and perceptual disorders and derealization. A second study with 30 patients with schizophrenia and with 2 or more relatives for each case (n = 69) demonstrated that the quality of relatives' reports depends primarily on the relative's image of the patient (e.g., perceived dominance) and on the relative's attributions 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.