Abstract
As a part of the ABC Schizophrenia Study, a large-scale investigation of the influences of age and gender on the onset and course of schizophrenia, this study compared retrospective reports about emerging symptomatology during the early course of schizophrenia given by patients and their significant others in a representative lirst admission sample. The Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS), a comprehensive interview assessing early signs and symptoms, revealed that, in most cases, patients as well as informants perceived negative, depressive, and unspecific symptoms as early signs of the disorder. Pairwise agreement about the presence of certain symptoms was good for a limited number of signs, e. g., substance abuse, suieidal behavior, parental and marital role deficits, and paranoid delusions. These items mainly concern abnormal behaviors that can be observed easily. In contrast, there was little agreement between reports about perceptual and formal thought disorder, i.e., subjective internal phenomena. The results supported a continuity model for the observability of symptoms in schizophrenia.
Similar content being viewed by others
References
Andreasen NC (1982) Negative symptoms in schizophrenia. Arch Gen Psychiatry 39: 784–788
Andreasen NC, Flaum M, Arndt S (1992) The comprehensive assessment of symptoms and history (CASH). An instrument for assessing diagnosis and psychopathology. Arch Gen Psychiatry 49: 615–623
Angermeyer MC, Klussmann D, Walpuski O (1988) The causes of functional psychoses as seen by patients and their relatives. II. The relatives' point of view. Eur Arch Psychiatry Neurol Sci 238: 55–61
Barrowclough C, Tarrier N, Watts S, Vaughn C, Bamrah JS, Freeman HL (1987) Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report. Br J Psychiatry 151: 1–8
Buchkremer G, Rath N (1989) Therapeutische Arbeit mit Angehörigen schizophrener Patienten. Meßinstrumente, Methoden, Konzepte. Huber, Bern Stuttgart Toronto
Crotty P, Kulys R (1985) Social support networks: the view of schizophrenic clients and their significant others. Soc Work 30: 301–309
Fiedler P, Niedermeier T, Mundt C (1986) Gruppenarbeit mit Angehörigen schizophrener Patienten. Materialien für die therapeutische Gruppenarbeit mit Angehörigen und Familien. Psychologie Verlags Union, Weinheim
Fleiss JL (1975) Measuring agreement between two judges on the presence or absence of a trait. Biometrics 31: 651–659
Goldstein JM, Kreisman D (1988) Gender, family environment and schizophrenia. Psychol Med 18: 861–872
Häfner H, Maurer K (1993) Epidemiology of positive and negative symptoms in schizophrenia. In: Shriqui CL, Nasarallah HA (eds) Contemporary issues in the treatment of schizophrenia. American Psychiatric Press, Washington, DC
Häfner H, Riecher-Rössler A, Hambrecht M, Maurer K, Meissner S, Schmidtke A, Fätkenheuer B, Löffler W, an der Heiden W (1992a) IRAOS: an instrument for the retrospective assessment of the onset of schizophrenia. Schizophr Res 6: 209–223
Häfner H, Riecher-Rössler A, Maurer K, Fätkenheuer B, Löffler W (1992b) First onset and early symptomatology of schizophrenia. A chapter of epidemiological and neurobiological research into age and sex differences Eur Arch Psychiatry Clin Neurosci 242: 109–118
Häfner H, Maurer K, Löffler W, Riecher-Rössler A (1993) The influence of age and sex on the onset and early course of schizophrenia. Br J Psychiatry 162: 80–86
Herz MI Melville C (1980) Relapse in schizophrenia. Am J Psychiatry 137: 801–805
Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country-study. Psychol Med Suppl 20
Mintz LI, Nuechterlein KH, Goldstein MJ, Mintz J, Snyder KS (1989) The initial onset of schizophrenia and family expressed emotion. Some methodological considerations. Br J Psychiatry 154: 212–217
Ohaeri JU (1992) Age at onset in a cohort of schizophrenics in Nigeria. Acta Psychiatr Scand 86: 332–334
Ohta Y, Nakane Y (1989) Features of schizophrenic patients and patients with depression as observed by family members-symptoms, social activities, and social performance. Jpn J Psychiatry Neurol 43: 29–36
Rist F, Watzl H (1989) Emotionale Reaktionen Angehöriger auf schizophrene Erkrankungen: Itemanalyse und Validierung der “Patient Rejection Scale” Z Klin Psychol 18: 134–143
Weissman MM, Wickramaratne P, Warner V, John K, Prusoff BA, Merikangas KR, Gammon GD (1987) Assessing psychiatric disorders in children. Discrepancies between mothers' and children's reports. Arch Gen Psychiatry 44: 747–753
Wing JK, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms: an instruction manual for the PSE and CATEGO Program, Cambridge University Press London
World Health Organization (1988) Psychiatric Disability Assessment Schedule (WHO/DAS). WHO, Geneva
Zedlick D, Maurer K, Löffler W, Riecher-Rössler A, Häfner H (1993) Der Frühverlauf der Schizophrenie und seine Beziehung zu Alter, Geschlecht und Diagnose bei stationärer Erstaufnahme. Neuropsychiatrie 7: 183–196
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hambrecht, M., Häfner, H. & Löffler, W. Beginning schizophrenia observed by significant others. Soc Psychiatry Psychiatr Epidemiol 29, 53–60 (1994). https://doi.org/10.1007/BF00805621
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00805621