Relationship between Self-Reported and Observer-Reported Ratings for Psychopathology in Psychiatric Inpatients

Abstract

Objective: Psychopathology can be measured adopting the perspective of clinicians or the perspective of patients themselves. In the present study, we investigated the degree of coherence between these two viewpoints. Methods: During an 8-month recruitment period, all consecutive patients admitted to two Italian residential facilities were screened for inclusion. The 24-item version of the Brief Psychiatric Rating Scale-Expanded Version (BPRS-E) and the Brief Symptom Inventory (BSI) were administered within the first 3 days since admission and immediately before discharge. Results: During the study period, 71 patients with psychosis (code F20–F29) and 80 patients without psychosis (code F30–F39 and code F60–F69) were included. In patients with psychosis, no correlation was observed between the BPRS-E total score and the General Severity Index (GSI) score at admission and before discharge. However, statistically significant correlations were found between the BPRS depression and anxiety subscale and the BSI subscales investigating affective and neurotic dimensions. In patients without psychosis, no correlation was observed between the BPRS-E total score and the GSI score at admission; conversely, at discharge, a statistically significant correlation was found between the BPRS-E total score and the GSI score, and between the BPRS-E depression and anxiety subscale and the BSI subscales investigating affective and neurotic dimensions. Conclusions: Self-reported and observer-reported ratings hold different meanings and cannot be considered equivalent. In terms of symptom dimensions, data showed that individuals tend to preserve the ability of measuring/assessing their own affective disturbances, even in the presence of psychotic symptoms, but not the ability of measuring/assessing loss of contact with reality.

Comparison of self-report and clinician-rated schizotypal traits in schizotypal personality disorder and community controls

“…In support of our hypothesis, SPQ subscale scores were significantly associated with their corresponding clinician-rated SIDP item scores for cognitive-perceptual (positive) schizotypal traits in both groups. This result is consistent with studies in schizophrenia suggesting that self-reported positive symptoms corresponded well with clinician ratings (Hamera et al, 1996;Lincoln et al, 2010;Liraud et al, 2004), although some studies have failed to find such correlations for positive symptoms (Biancosino et al, 2007;Morlan and Tan, 1998). Positive schizotypal traits may be more accurately self-reported as the SPQ asks about these items directly (e.g., "Do you sometimes feel that things you see on the TV or read in the newspaper have a special meaning for you?…”

Correlations between self‐rating and observer‐rating of psychopathology in at‐risk mental state and first‐episode psychosis patients: influence of disease stage and gender

“…As we found statistically significant correlations with both positive and negative symptoms, our results do not confirm earlier findings of Hamera et al 9 and Preston and Harrison, 10 according to whom negative symptoms are more difficult to be accurately reported than positive symptoms, but support earlier findings of Bell et al 12 and Liraud et al 11 The lack of association between scales measuring affective symptoms stands in contrast to previous studies which reported good agreements in this dimension. 1,15 With regard to the moderating influence of the disease stage, we could not confirm that the association between self-rating and observer-rating is higher in ARMS than in FEP patients. However, when P-values were not corrected for multiple testing, there was one significant interaction which was in the opposite direction of what we had expected.…”

“…poor insight, denial, delusions, cognitive deficits) that could hinder an accurate self‐rating of their symptoms, it has long been assumed that self‐ratings – especially of positive psychotic symptoms – are unreliable in these patients . However, our literature research revealed that at least six studies found a good agreement between self‐rating and observer‐rating of positive psychotic symptoms in psychosis patients and only three studies found poor correlations …”

“…8,9 However, our literature research revealed that at least six studies found a good agreement between self-rating and observer-rating of positive psychotic symptoms in psychosis patients 3,4,[9][10][11][12] and only three studies found poor correlations. [13][14][15] With respect to negative symptoms, the concordance between self-and observer-rating scales seems to be rather inconsistent. Some studies found negative symptoms more difficult to be accurately reported than positive symptoms, 3,9,10 whereas other studies suggested that even patients with a schizophrenic, schizoaffective or acute psychotic disorder are able to accurately report them.…”

“…Studies assessing the concordance between selfrating and observer-rating of depressive symptomatology in psychosis patients mostly showed good agreements. 13,15,17 A recent study identified 49.2% of the patients to have equal self-rating and observerrating in depressive symptoms. 1 However, Lasalvia et al 14 found significant correlations between affective symptoms only in non-psychosis but not in psychosis patients.…”