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October 1975

Concordance of Multiple Assessments of the Outcome of Schizophrenia: On Defining the Dependent Variable in Outcome Studies

Author Affiliations

From the departments of psychiatry, College of Physicians and Surgeons, Columbia University, New York (Dr. Schwartz); and Yale University School of Medicine, New Haven, Conn (Dr. Astrachan); and the Department of Sociology, Yale University (Dr. Myers).

Arch Gen Psychiatry. 1975;32(10):1221-1227. doi:10.1001/archpsyc.1975.01760280019001

• Concordance of multiple assessments of the outcome of schizophrenia are examined from (1) concordance of three different assessments of mental status, and (2) concordance of four different dimensions of outcome. Findings are related to the methodological issue of defining the dependent variable in outcome studies.

When the assessment instruments were compared, discordance in overall assessment happened because each instrument taps varying aspects of symptomatology, suggesting that outcome is somewhat instrument-related. Although adjustment in mental status is correlated with social adjustment and role performance, a patient's status at follow-up bears little relationship to rate of rehospitalization or to consumer satisfaction with treatment. A differential impact of the same predictor variables on four dimensions of outcome underscores the discordance in multiple assessments. Since treatment outcome is multifaceted and multidetermined, multiple assessments must continue as vital procedures.

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