Comparison of self- and clinician's ratings of Personal and Social Performance in patients with schizophrenia: the role of insight.
BACKGROUND
Patients with schizophrenia are often markedly impaired in their social functioning, partly independent of symptom severity. Few studies have examined patients' self-reporting of their social functioning, how a patient's self-perspective differs from third-party ratings, and whether or not the patients' self-rating of social functioning is influenced by their awareness of illness.


METHODS
Based on the Personal and Social Performance (PSP) scale as a clinician-administered scale, a PSP self-rating scale for patients was developed. The study included 42 inpatients with schizophrenia. Instruments were the PSP scale, the PSP self-rating scale, the Clinical Global Impression-Severity Scale, and the Scale to Assess Unawareness of Mental Disorder.


RESULTS
A significant correlation was found between PSP self- and clinician's rating for 'socially useful activities', whereas the other PSP subdimensions as well as the total score were not significantly correlated. For patients with high insight, a significantly positive association emerged with 'disturbing and aggressive behaviour', while there was no significant correlation between PSP self- and clinician's ratings for the patients with poor insight into their disorder.


CONCLUSIONS
Patients and clinicians only marginally converge on their judgments concerning the patients' psychosocial functioning. Patients' insight may have a moderating role on the approximation of agreement between self- and third-party ratings. Results are discussed in line with the present literature regarding the accuracy of self-awareness in schizophrenia.
Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Bochum, Germany. d_schaub@arcor.de
Daniela
D
Schaub
Martin
M
Brüne
Hans-Werner
HW
Bierhoff
Georg
G
Juckel
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D057566:Self Report; D012647:Self-Assessment; D012720:Severity of Illness Index; D012919:Social Behavior