Heun R, Müller H
Department of Psychiatry, University of Bonn, Germany.
Eur Arch Psychiatry Clin Neurosci. 1998;248(2):104-9. doi: 10.1007/s004060050025.
Knowledge on the reliability of family history information is essential for every family study. However, systematic analyses of interinformant reliability of family history information on individual relatives have not yet been published. Consequently, family history information on 1306 first-degree relatives and spouses of patients and of control subjects was collected from at least two other family members using questionnaires. Interinformant reliability was acceptable for dementia [Kappa = 0.58, 95% confidence interval (CI) = 0.48-0.68], but less so for alcoholism (Kappa = 0.41, CI = 0.23-0.59), depression (Kappa = 0.26, CI = 0.14-0.38) and anxiety disorders (Kappa = 0.19, CI = 0.05-0.43). Demographic variables of subjects and informants and their familial relationship did not influence diagnostic agreement on the diagnosis of dementia. Diagnostic agreement on depression was significantly reduced when information from siblings of index subjects was compared with information from spouses of index subjects. The interinformant agreement for the diagnosis of depression was higher in younger than in older subjects (relative risk for disagreement 1.08/additional year, CI = 1.02-1.15). Siblings of index subjects seem to provide different, but not necessarily less relevant, family history information in comparison with other relatives. Researchers should be aware of the problem that depression in the elderly can be easily missed by family history. It seems more important for the diagnosis of depression than for a diagnosis of dementia to get information from multiple informants.
了解家族病史信息的可靠性对每项家族研究都至关重要。然而,关于个体亲属家族病史信息的信息提供者间可靠性的系统分析尚未发表。因此,使用问卷从至少另外两名家庭成员那里收集了1306名患者及对照对象的一级亲属和配偶的家族病史信息。信息提供者间对痴呆症的可靠性是可以接受的(卡帕值=0.58,95%置信区间[CI]=0.48 - 0.68),但对酗酒(卡帕值=0.41,CI=0.23 - 0.59)、抑郁症(卡帕值=0.26,CI=0.14 - 0.38)和焦虑症(卡帕值=0.19,CI=0.05 - 0.43)的可靠性则较低。受试者和信息提供者的人口统计学变量及其家族关系并未影响痴呆症诊断的诊断一致性。当将索引对象的兄弟姐妹提供的信息与索引对象的配偶提供的信息进行比较时,抑郁症的诊断一致性显著降低。抑郁症诊断的信息提供者间一致性在年轻受试者中高于老年受试者(每增加一岁不一致的相对风险为1.08,CI=1.02 - 1.15)。与其他亲属相比,索引对象的兄弟姐妹似乎提供了不同但不一定不相关重要的家族病史信息。研究人员应意识到家族病史可能容易遗漏老年人抑郁症这一问题。对于抑郁症的诊断而言,从多个信息提供者那里获取信息似乎比诊断痴呆症更为重要。