Relationship between self-reported and observer-reported ratings for psychopathology in psychiatric inpatients

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.

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.

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.

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.