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Factores que influyen en la validez de los informes de los familiares sobre los síntomas del primer episodio de esquizofrenia

Published online by Cambridge University Press:  12 May 2020

M. Hambrecht*
Affiliation:
Clínica y Policlínica para Psiquiatría y Psicoterapia de la Universidad de Colonia, Colonia, Alemania
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Resumen

Se necesita información válida sobre el curso temprano de la esquizofrenia para fines clínicos y de investigación, por ejemplo, para determinar el comienzo del trastorno. Puesto que los informes proporcionados por los pacientes psicóticos son cuestionables, a menudo se pide a los familiares que comuniquen sus observaciones. Para comprobar la calidad de estos informes, se evaluaron sistemáticamente las informaciones sobre la aparición de síntomas de 30 pacientes esquizofrénicos postpsicóticos cuya enfermedad había comenzado hace poco y de 69 informantes (sobre todo, sus familiares próximos) por medio de la Entrevista para la Evaluación Retrospectiva del Comienzo de la Esquizofrenia (IRAOS). Se compararon las tasas de acuerdo paciente-informante, como el coeficiente kappa, entre los familiares de cada caso individual. Análisis de regresión múltiple demostraron que la personalidad y los factores atribucionales, en particular las atribuciones causales y la imagen que el o la informante tiene sobre sí mismo y sobre el paciente, determinan la calidad de sus informes. Los familiares que describieron al paciente como “dominante” y a sí mismos como “reservados”, y que atribuyeron la enfermedad al estres psicosocial actual, por ejemplo, alcanzaron los coeficientes kappas más altos en todos los síntomas. El contacto prolongado y estrecho con el paciente tiende a deteriorar la calidad de los informes.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 1998

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