Am J Psychiatry 1994; 151:568-573
Copyright © 1994 by American Psychiatric Association
Concordance between patients and informants on the personality disorder examination
LP Riso, DN Klein, RL Anderson, PC Ouimette and H Lizardi
Department of Psychology, State University of New York at Stony Brook.
OBJECTIVE: Difficulties in the assessment of personality disorders and the
burgeoning interest in axis II have led to increased use of informants when
studying these conditions. The present study sought to evaluate the
correspondence between patients and their informants on symptoms of
personality disorders. METHOD: A total of 105 outpatients and knowledgeable
informants were independently interviewed by using the Personality Disorder
Examination, a widely used instrument for the full range of personality
disorders. RESULTS: Diagnostic concordance between interviews was low
(median kappa = -0.01), while correlations between dimensional scores were
somewhat higher (median kappa = 0.36). Overall, patient interviews showed
more pathology than interviews with informants. However, many of the
symptoms obtained from informants were not reported by patients.
CONCLUSIONS: These data suggest that patient- informant concordance for
axis II disorders is poor for diagnoses but somewhat better for dimensional
scores. There was no evidence that low agreement can be explained by
patients attempting to present themselves in a favorable light. Further
work is necessary to elucidate the reasons for discordance and determine
which data source provides the most valid information.
