Sensitivity and specificity of relatives' reports on the early course of schizophrenia

Within the ABC Schizophrenia Study, a large-scale investigation of the influences of age and gender on schizophrenia, the retrospective reports on emerging psychopathology during the early course of schizophrenia given by 171 post-psychotic patients and their significant others were compared in a representative first-admission sample by means of the Interview for the Retrospective Assessment of the Onset and Early Course of Schizophrenia. High agreement (kappa) between patients and relatives was found for substance abuse, suicidal behaviour, parental and marital role deficits, and paranoid delusions. Low positive agreement rates (sensitivity) were seen for perceptual and formal thought disorders. Low negative agreement rates (specificity) were found for depression, anxiety, and similar "unspecific' symptoms. Relatives' reports are helpful but should be used with caution.