Anomalías de la experiencia subjetiva en psicosis: Concepto y validación empírica del modelo de los Síntomas Básicos / Anomalies of subjective experience in psychosis: Concept and empirical validation of the Basic Symptoms model

Introducción Tradicionalmente, en la investigación, el diagnóstico y el tratamiento de los trastornos del espectro psicótico ha imperado un modelo de comprensión objetivista, centrado principalmente en los síntomas positivos y negativos. Aunque es innegable el valor de esta aproximación, implica considerables limitaciones ampliamente conocidas. De forma complementaria, existe una larga y prometedora tradición fenomenológica en la cual la experiencia subjetiva del síntoma del paciente adquiere una importancia fundamental. La aproximación de las anomalías de la experiencia subjetiva o, específicamente, de los Síntomas Básicos ha adquirido mucha fuerza dentro del contexto de detección precoz de psicosis y esquizofrenia. Objetivo Esta revisión expone la aproximación fenomenológica de las anomalías de la experiencia subjetiva y se define detalladamente el modelo de los Síntomas Básicos, así como su proceso de validación empírica en el campo de detección precoz de psicosis. Método Las bases de datos consultadas han sido PubMed Central® y PsycINFO®, así como libros de autores de referencia. Resultados En las dos últimas décadas ha habido un creciente interés científico sobre esta orientación con resultados muy prometedores. Discusión y conclusión El modelo más destacado a nivel empírico es el de los Síntomas Básicos, aunque recientemente también han ganado gran relevancia las alteraciones del flujo de la consciencia o del self. Se ha comprobado que las anomalías de la experiencia subjetiva consiguen delimitar un perfil de riesgo de psicosis más temprano que los síntomas psicóticos atenuados. Por tanto, son un complemento altamente válido en las estrategias de detección e intervención temprana de psicosis.

Introduction Research, diagnosis and treatment of psychotic spectrum disorders have been traditionally dominated by an objectivist approach to their understanding, being primarily focused on positive and negative symptoms. The value of this approach goes without question, but it also involves considerable and widely known limitations. From a complementary perspective, there is a longstanding and promising phenomenological tradition in which the subjective experience of the patient's symptom becomes crucial. The focus on the anomalies of subjective experience, or the Basic Symptom concept specifically, has gained much momentum in the context of early detection of psychosis and schizophrenia. Objective This review presents the phenomenological approach to the anomalies of subjective experience and the Basic Symptoms model and its empirical validation process in the field of early detection of psychosis. Method The scientific literature was collected from PubMed Central® and PsyclNFO® databases and books from authors of reference. Results In the last two decades there has been a growing scientific interest in this approach with very promising results. Discussion and conclusion The most prominent model from an empirical standpoint is the Basic Symptoms approach, although recently the disturbances of the flow of consciousness or self disorders have achieved great relevance as well. It has been found that the anomalies of subjective experience could delimitate a risk profile that precedes that defined by attenuated psychotic symptoms. Therefore, this approach is a highly valuable complement in the early detection and intervention of psychosis strategies.

Spanish version of the Psychosis Attachment Measure: adaptation process and psychometric properties / Proceso de adaptación al español y propiedades psicométricas de la Psychosis Attachment Measure

Introduction Attachment theory has recently been postulated as a useful framework for enhancing our understanding of the role of psychosocial and environmental factors in relation to the vulnerability, expression, and course of psychosis. In this paper we present the Spanish adaptation and psychometric properties of the Psychosis Attachment Measure (PAM), a 16-item self-report scale specifically designed to measure adult attachment in people with psychosis. Method In study 1, the PAM was adapted into Spanish following the translation/back-translation procedure and was administered to 24 early psychosis patients to evaluate its intelligibility. In study 2, the psychometric properties of the scale were assessed in a sample of 235 university students. The students completed the PAM and the Relationship Questionnaire (RQ) via an Internet website. Results Results from study 1 demonstrated that the Spanish version of the scale is semantically and conceptually equivalent to the original English version and that it is appropriate for use with people experiencing psychotic symptoms. Paralleling the findings from the English version of the instrument, results from study 2 indicated that two factors, conceptually representing anxiety and avoidance, underlie the Spanish version of the PAM. The anxiety and avoidance subscales were found to have adequate levels of internal reliability and to be associated in a theoretically predicted fashion with the four prototypes of adult attachment measured with the RQ. Discussion The good psychometric properties exhibited by the instrument support its use for the assessment of adult attachment styles in the Spanish cultural context and allow for the comparability of findings across cultures. Having a Spanish instrument for assessing attachment in psychosis populations is a relevant contribution that opens up new avenues for research and clinical applications.

Introducción Recientemente se ha postulado a la teoría del apego como un marco conceptual de gran utilidad para mejorar la comprensión del papel de los factores psicosociales y ambientales en relación con la vulnerabilidad, expresión y curso evolutivo de la psicosis. En este artículo presentamos la adaptación española y las propiedades psicométricas de la Psychosis Attachment Measure (PAM), una escala de 16 reactivos diseñada para medir el apego adulto en población con psicosis. Método En el estudio 1, la PAM se adaptó al español siguiendo la metodología de traducción/retrotraducción y se administró a 24 pacientes con psicosis temprana para evaluar su comprensión del instrumento. En el estudio 2 se analizaron sus propiedades psicométricas en una muestra de 235 estudiantes universitarios. Los estudiantes completaron la PAM y el Cuestionario de Relación (RQ) a través de una página de Internet. Resultados Los resultados del estudio 1 demostraron que la adaptación del instrumento es conceptual y semánticamente equivalente a la versión original en inglés y que es apropiada para usarse en personas que presentan síntomas psicóticos. Replicando los hallazgos obtenidos con la medida original, los resultados del estudio 2 indicaron que dos factores, que conceptualmente representan ansiedad y evitación, subyacen a la versión española de la PAM. Las subescalas de ansiedad y evitación mostraron tener una consistencia interna adecuada, así como estar asociadas de forma teóricamente coherente con los cuatro prototipos de apego medidos con el RQ. Discusión La escala presenta unas propiedades psicométricas adecuadas, lo cual apoya su utilización para la evaluación de los estilos de apego adulto en el contexto cultural español y hace posible la comparación de resultados obtenidos en diferentes culturas. Disponer de un instrumento en español para evaluar el apego en población con psicosis es una aportación relevante que abre nuevos panoramas en ámbitos clínicos y de investigación.

The need-adapted integrated treatment in Sant Pere Claver-Early Psychosis Program (SPC-EPP) in Barcelona, Spain / El tratamiento integrado y adaptado a las necesidades del Programa de Psicosis Incipiente-Sant Pere Claver (PPI-SPC) en Barcelona, España

International interest has grown over the past 15 years in the prognostic potential of early identification and intervention in the prodromal and first-episode phases of psychosis. This focus is associated with increasing optimism about the benefits of implementing treatment as early as possible in the course of psychosis, at least to help improve the course of illness, reducing its long-term impact. A clearer framework for guiding, designing, and evaluating preventive interventions in mental disorders has been developed. As a consequence, a series of research projects and real-world services systems are currently emerging. Additionally, several influential international figures and research groups have developed and cooperated in disseminating a more optimistic set of ideas concerning early intervention in psychosis. The early psychosis programs developed worldwide have a number of common elements and goals: a) early detection of new cases, b) reducing the duration of untreated psychosis (DUP), and c) providing better and continued treatment during the <

Los trastornos del espectro psicótico presentan un curso crónico y episódico que provoca alteraciones en todas las áreas de la vida, generando importantes grados de discapacidad, pérdida de funciones psicosociales, grandes costes económicos, una comorbilidad considerable y sufrimiento tanto para los pacientes como para sus familias. A pesar de que el tratamiento farmacológico y psicosocial ha ayudado a aliviar los síntomas y mejorar la calidad de vida, en muy pocas ocasiones se logra una recuperación satisfactoria en los niveles psicológico y funcional. Durante los últimos 15 años, el optimismo creciente sobre la posibilidad de mejorar el pronóstico de la psicosis y alterar con ello el tradicional curso negativo de la enfermedad, ha producido una reforma sustancial en la práctica clínica y en el desarrollo de estrategias de intervención temprana en muchos países. De esta manera, el desplazamiento del foco de atención desde las fases estables o residuales de la psicosis hacia los inicios de la misma está suponiendo una serie de innovaciones y avances, tanto en la evaluación y diagnóstico, como en las modalidades terapéuticas y en la consiguiente reordenación de los servicios asistenciales. Cada vez existen más grupos en todo el mundo que establecen programas clínicos e iniciativas de investigación centradas en la psicosis temprana. Cada uno de estos programas tiene características particulares y rasgos propios en cuanto a las modalidades de tratamiento o los instrumentos de evaluación, pero la mayoría comparte una serie de elementos y objetivos en común: a) detectar de forma precoz nuevos casos; b) reducir el periodo de tiempo desde que el paciente presenta una sintomatología claramente psicótica hasta que recibe un tratamiento adecuado (duración de la psicosis no tratada); y c) proporcionar un mejor y continuo tratamiento en el <

Rationale and state of the art in early detection and intervention in psychosis / Justificación y estado de la cuestión en la detección e intervención temprana en psicosis

Schizophrenia-spectrum disorders have a chronic and episodic course that results in impairment of all life domains. Pharmacological and psychosocial treatments provide symptom relief, but there is not a cure for schizophrenia and many patients suffer chronic impairment. In addition, it is expensive both in economical terms and also in terms of personal costs for both patients and their families. International interest has grown over the past 15 years in the prognostic potential of early identification and intervention in the prodromal and first-episode phases of psychotic illness. This focus is associated with increasing optimism about the benefits of implementing treatment as early as possible in the course of psychosis at least to help improve the course of illness, reducing its long-term impact. The most recent epidemiological studies have shown that patients with longer duration of untreated psychosis (DUP) have worse short-term outcomes in terms of treatment response, positive symptoms, negative symptoms, and global functioning. Neuroimaging studies have also indicated that prolonged untreated illness is associated with more pronounced structural brain abnormalities, while this is less prominent earlier in the course of the disorder. Therefore, early detection aims to reduce treatment delay in the hope of improving prognosis and reducing illness severity. Early intervention in psychotic disorders has gained momentum in the last decades, and there is now an estimated 200 centers worldwide offering specialized services for young people experiencing their first episode of psychosis. Each of these programs has unique characteristics and distinctive features in terms of treatment modalities and assessment tools, but most have a number of common elements and goals: a) early detection of new cases, b) reducing DUP, and c) providing better and continued treatment during the «critical period¼ of the early years of the disease. Moreover, the role of family work in early psychosis can be crucial given that relatives are the main informal caretakers of persons with mental health problems. Family interventions in early psychosis usually offer psychoeducation and/or individual and group family therapy, communication and problem solving training, which can help to develop coping strategies and reduce distress and burden. Intervention programs in early psychosis are usually composed by interdisciplinary teams, providing a wide range of integrated services that typically include psychoeducation, clinical case management, and group interventions. Specific interventions generally include pharmacotherapy, stress management, relapse prevention, social and employment rehabilitation support, and cognitive and family therapy. Given the complex etiology and clinical manifestation of psychosis, treatment packages for people experiencing early psychosis need to be individually tailored to specific needs rather than applied homogenously across early psychosis patients. The current challenge in the implementation of psychological interventions in the early stages of psychosis are: 1. to adapt treatment modalities that have been proven effective in stable and residual stages of the disease to its early stages; 2. to develop new forms of therapy tailored to the specific characteristics of these early stages of psychosis (prodromal and ultra high-risk phase, onset and first episode psychosis, and «critical period¼ or post-crisis psychosis); and 3. treatment packages need to be individually tailored to their specific needs rather than applied homogenously across a group of patients. The aims of this paper are: 1. to present the basic concepts, rationale and state of the art of the early detection and intervention paradigm; 2. to review and present the main detection and intervention programs in early psychosis and 3. to provide an overview of the current psychotherapeutic approaches in early psychosis.

Los trastornos del espectro psicótico presentan un curso crónico y episódico que provoca alteraciones en todas las áreas de la vida, generando importantes grados de discapacidad, pérdida de funciones psicosociales, grandes costos económicos, una comorbilidad considerable y sufrimiento tanto para los pacientes como para sus familias. A pesar de que los tratamientos farmacológicos y psicosociales han ayudado a aliviar los síntomas y mejorar la calidad de vida, en muy pocas ocasiones se logra una recuperación satisfactoria a nivel psicológico y funcional. Durante los últimos 15 años, el optimismo creciente sobre la posibilidad de mejorar el pronóstico de la psicosis y alterar con ello el tradicional curso negativo de la enfermedad ha producido una reforma sustancial en la práctica clínica y en el desarrollo de estrategias de intervención temprana en muchos países. De esta manera, el desplazamiento del foco de atención desde las fases estables o residuales de la psicosis hacia los inicios de la misma está suponiendo una serie de innovaciones y avances, tanto en la evaluación y diagnóstico como en las modalidades terapéuticas y en la consiguiente reordenación de los servicios asistenciales. Los estudios epidemiológicos más recientes han mostrado que los pacientes con mayor duración de la psicosis no tratada tienen peor respuesta al tratamiento farmacológico, mayor gravedad de síntomas positivos, síntomas negativos y peor funcionamiento global. Por otra parte, los estudios de neuroimagen también indican que un periodo prolongado de enfermedad no tratada produce anormalidades estructurales cerebrales más pronunciadas. Es por esto que la detección temprana en psicosis tiene como objetivo reducir la demora del tratamiento para mejorar el pronóstico y reducir la gravedad del trastorno. La detección temprana y la aplicación del tratamiento específico más eficaz para cada fase inicial del trastorno son dos elementos que diferencian la intervención temprana de las formas habituales de asistencia actuales. Cada vez existen más grupos en todo el mundo dedicados a establecer programas clínicos e iniciativas de investigación centradas en la psicosis temprana. Cada uno de estos programas tiene características particulares y rasgos propios en cuanto a las modalidades de tratamiento o los instrumentos de evaluación, pero la mayoría tiene una serie de elementos y objetivos en común: a) detectar de forma precoz nuevos casos; b) reducir el periodo de tiempo desde que el paciente presenta una sintomatología claramente psicótica hasta que recibe un tratamiento adecuado y c) proporcionar un mejor y continuo tratamiento en el «periodo crítico¼ de los primeros años de la enfermedad. En el contexto de la prevención e intervención temprana, el trabajo con la familia puede ser crucial, ya que los familiares son los principales cuidadores informales y son una parte fundamental para la recuperación del paciente. La mayoría de las intervenciones familiares ofrecen psicoeducación y/o terapia familiar que ayudan a desarrollar estrategias de adaptación y afrontamiento, disminuir el estrés y la carga a largo plazo, así como mejorar la comunicación y la resolución de problemas. Los programas de intervención en la psicosis temprana están habitualmente formados por equipos interdisciplinarios que proporcionan una amplia serie de servicios integrados que suelen incluir psicoeducación, manejo clínico de casos e intervenciones grupales. Las intervenciones específicas incluyen generalmente farmacoterapia, manejo de estrés, prevención de recaídas, apoyo y rehabilitación social y laboral, así como terapia cognitiva y familiar. Dada la compleja etiología y manifestación clínica de la psicosis, los tratamientos para personas con psicosis incipiente deben ser adaptados individualmente a las necesidades específicas en lugar de aplicarlos homogéneamente a todos los pacientes por igual. El desafío actual en la aplicación de intervenciones en la psicosis temprana consiste en: 1. conseguir adaptar aquellas modalidades de tratamiento que ya han demostrado su eficacia en las fases estables y residuales de la enfermedad a los inicios de la misma; 2. integrar y desarrollar nuevas formas de terapia que se adapten a las características específicas de cada una de las fases iniciales de la psicosis (fase prodrómica o de alto riesgo, inicio de la psicosis o primer episodio de psicosis y «fase crítica¼ o poscrisis) y 3. adecuar los tratamientos de manera individual en vez de aplicarlos de forma homogénea. Los objetivos del presente artículo son: 1. presentar los conceptos básicos, la justificación y el estado de la cuestión del paradigma de detección e intervención temprana en psicosis; 2. hacer una revisión y presentar los principales programas de detección e intervención temprana en psicosis y 3. proporcionar una visión general de los enfoques psicoterapéuticos actuales en psicosis incipiente.

Predictors of short-term course in Mexican first-episode psychosis patients / Predictores de curso temprano en pacientes mexicanos con primer episodio psicótico

Background and objectives The identification of prognostic factors in patients with schizophrenia and related psychotic disorders should enhance our understanding of the aetiology of these disorders and improve their treatment. The first years following an initial episode of psychosis are a <

Antecedentes y objetivos La identificación de factores pronósticos en pacientes con esquizofrenia y otros trastornos psicóticos relacionados podría facilitar la comprensión de la etiología de estos trastornos así como mejorar los tratamientos existentes. Los primeros años a partir del primer episodio psicótico son un <

Evaluación de la conducta adolescente con las Escalas de Achenbach: ¿existe concordancia entre diferentes informantes?

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Summary: Introduction Behavioural problems in adolescents are thought to be relevant as strong predictors for the detection of other psychological disorders. For this reason and due to the importance they present by themselves, carrying out an adequate assessment of them is fundamental. Mental health professionals have diverse opinions about the value and importance of the different informants. The majority choose of their sources according to the disorder and necessities of each evaluator. On the other hand, the need to obtain data about adolescents' functioning from multiple resources has been emphasised and numerous reasons have been exposed. Concretely, the fact of carrying out the most objective and complete evaluations as possible has been considered essential in those studies aimed at evaluating behavioural alteration in adolescents. For this reason, Achenbach developed three versions of his scale: one for the parents, another for the teachers and a third one for the adolescents themselves. Numerous investigations have studied the concordance between groups of informants about different behavioural alterations in adolescents, but none have carried out a complete analysis of all informants in all subscales (not only the total ones). For this reason, the current study has been developed with the aim of contributing to obtain an enriching vision for the professional in the field. Objectives. a) To systematically explore agreement patterns between adolescents, teachers and parents who inform of behavioural problems in adolescents in the general population and b) in those cases in which no agreement is found, to analyse the level of disagreement between each pair of informants for each subscale. Methodology. Cross-sectional and descriptive study Participants. The study was formed by 160 triads of parents, teachers and 13-16 year old adolescents selected from several schools in Barcelona. Instruments. The three forms of the Achenbach scale to measure behavioural alterations were applied. The scale was translated into Spanish by the Unit of Epidemiology and Diagnostic in Psychopathology of the Development of the Universidad Autónoma de Barcelona: Youth Self-Report, self-evaluated, Child Behaviour Checklist/4-18 and Teacher's Report Form, both heteroevaluated and completed by parents and teachers, respectively. These three forms contain a 89-item set that evaluates the same behaviour, where eight items are organised in scales of syndromes derived empirically and which are invariant throughout informants. The eight subscales are: withdrawn, somatic complaints, anxious/depressed, social problems, thought problems, attention problems, delinquent behaviour and aggressive behaviour. Some of them are grouped in second order factors: the first three in internalising, the last two in externalising, and the rest of them provide a total problems punctuation. Statistical procedure. Agreement values were analysed for each pair of informants and each subscale through the Intraclass Correlation Coefficient (ICC). A value below 0.40 indicates low concordance. In these cases, the statistical analysis proceeds with the discordance analysis by pairs of informants and for each subscale through the Bland Altman Method. Results. A low concordance (below 0.40) between informants was found especially in internalizing scales (0.230). A slightly higher value was found in attention (0.334), aggressive behaviour (0.371), externalizing (0.357), and total subscales (0.327). Secondly, it was observed that, when informing about somatic complains, thought and attention problems, internalising items and the total scale, parents reported more alterations, followed by adolescents and teachers. Also, parents indicated more withdrawal problems in adolescents, although in this case they were followed by teachers and adolescents themselves. Finally, in the evaluation of the anxiety/depression scales, social problems, delinquent behaviour, aggressiveness and externalising conducts, adolescents informed of more alterations followed by their parents, and then by the teachers. Regarding the agreement/disagreement variability throughout the scales scores, the discordance between different informants was higher when the punctuation was further away from normality, generally when the scales were scored higher. Discussion. The normative criteria of comparison and the reference frames for each group of informants are different. For instance, the fact that teachers report less behavioural alterations could be explained because of their familiarity in dealing with adolescents and a higher tolerance towards some behaviors. In general terms, this result fits in with most conclusions from investigations carried out in this field. On the other hand, the fact that parents inform of more internalising problems could be attributed to adolescent behaviour which would in turn alter the family context. Another explanation might be that parents are on the whole more implicated and more sensitive in detecting certain conducts or behavioural alterations in their offspring. In any case, it is disputable whether the lack of concordance between the different informants does really exist or, on the contrary, adolescent behaviour changes depending on the context. Finally, a result contradicting those found in the studies reviewed is that adolescents are the ones who report more externalising problems. Other authors have found that adolescents inform more about internalising problems, something which should be expected taking into account that they are the ones who know themselves better. This could be possibly explained by the presence of more social desirability/undesirability among the adolescents of our sample in front of their pair group when answering to the evaluation scales; this may be due to the group context in which the case was applied. The main limitation of the present study that it was carried out with a general population sample, although from another point of view this may be considered as a gain of the study. We recommend carrying out explicative studies about discordance, which could clarify the predictive validity of each informant group and make variations in the type of sample under study. Conclusions. Data from different sources contribute with specific information of relative validity. This is why a multidimensional, multisituational and mulitiinformant approach is fundamental. This is necessary not only to evaluate behavioural alterations in adolescents within a research context, but also when taking diagnostic decisions in a clinical context, because, depending on the chosen informant, the diagnostic criteria for one disorder or another might change. Also, our results imply that there may be an underdetection of behavioural problems in adolescents by the adults, which would result in a lower psychological demand than the necessary.

¿Explica la esquizotipia la discordancia entre informantes de alteraciones conductuales adolescentes?

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Summary: Introduction. Behavioural alterations are a quite potent predictor for schizophrenia. Very often, apparently healthy adolescents (who will later develop schizophrenia) present altered conducts similar to those manifested by schizophrenic subjects and as predictors for the disorder. There are studies that describe the relationship between these behavioural alterations and the features found in schizotypical personality disorder or schizophrenic symptoms. In this way, it has been established that those subjects who obtain high scores in schizotypy present more behavioural alterations. Concretely, the different behavioural alterations have been differentially related to the positive and negative subtypes of the schizotypical personality, suggesting continuity between the nature of premorbid conducts and the adult symptoms patterns in which the illness develops. On the other hand, comparing adolescents that will later develop schizophrenia with those who will not, it has been found that the best schizophrenia predictor is a poor behavioural adjustment. Moreover, if the teachers' reports are examined, there can be certain aspects such as the early behavioural patterns which will identify children who, for instance, will develop schizophrenia thirty years later, or even differential patterns according to the gender of the subjects. Therefore, if we want to carry out a schizophrenia prediction according to these behavioural criteria, knowing which informants are more useful and how their opinions match among them is of a great interest. Until this moment, the majority of studies have pointed out at the ability of teachers to identify conducts that can be used to select people at risk for schizophrenia. However, having into account that numerous studies conclude that there is a lack of agreement between these and other different informants for behavioural alterations in adolescents, the importance of studying the variables that can be influencing this matter must be raised. Following with the line of our research group a question is raised. We wonder if the presence of schizotypical personality traits makes the adolescents behaviour more ambiguous, with the consequent difficulty to define it in a coincident way from different evaluators and from themselves. Objectives. To analyse the influence of the schizotypical personality (assessed with the Oxford-Liverpool Inventory of Feelings and Experiences), the demographic variable gender and the interaction between them, in the discordance of different informants (parents, teachers and adolescents) when they inform about behavioural problems in adolescents (assessed with the Achenbach's scales). Methodology. This is an analytic transversal study that can be framed into a longitudinal study of 2 cohorts from the general population, which started on 2000 and has been then followed-up ("Psychoeducation program and early detection of schizophrenic disorders of adolescent onset"). Participants. 160 triads of parents, teachers and adolescents from 13 to 16 years old selected from 7 schools of Barcelona took part in the study. Instruments. The three forms of the Achenbach scale for the measure of behavioural alterations were applied: Youth Self- Report, Child Behaviour Checklist/4-18 and Teacher's Report Form. These forms contain 8 scales which are invariant throughout informants: Withdrawn, somatic complaints, anxious/depressed, social problems, thought problems, attention problems, delinquent behaviour and aggressive behaviour. Some of them are grouped in second order factors: Internalizing, externalizing and total. To evaluate the psychometrical schizotypical personality of adolescents we used the Oxford-Liverpool Inventory for Feelings and Experiences. It consists of an autoadministered inventory with 159 items that includes four schizotypical scales. The Unusual Experiences scale reflects the positive dimension of schizotypy and includes items of unusual perception aberrations and magical thinking. The Introvert Anhedonia Scale reflects the negative dimension of schizotypy and consists of items assessing restricted affect, social isolation and anhedonia. The Cognitive Disorganization Scale refers to disorganized aspects of the psychosis and it is composed of items assessing difficulties in concentration and decision-making. Finally, the Impulsive Nonconformity Scale reflects the characteristics of impulsive-type personality, social anxiety and maladjusted behaviours. Statistical proceed. Multiple regression analyses were carried out in order to revise the influence of the schizotypical personality, the demographic variable gender and the interaction between them as possible explicative variables, in the discordance between different informants about behavioural problems of adolescents. The dependent variable was a measure of the level of discordance between the three groups of informants. Results. A major discordance between informants of behavioural problems was found as schizotypy was higher. Concretely, a larger number of unusual experiences in adolescents increase the discordance for thought and internalizing problems. Discordance is also higher in aggressiveness and anxiety/depression as cognitive disorganization increases. Also, the higher the introverted anhedonia, the higher the discordance is for social problems, anxiety/depression, attention, externalizing problems, and for the total. To finish, a high score in non-conformity impulsivity increases the discordance for attention, delinquency and aggressive problems. About the influence of gender, discordance between informants for anxiety/depression is higher for females than for males. However, this varies when the interaction effects found are considered. In this way, a differential effect for the increase of non-conformity impulsivity and introvert anhedonia can be observed in males and females. Therefore, discordance between informants is higher when evaluating anxiety/ depression in males when non-conformity impulsivity is high. Just the opposite happens for girls. In addition, the discordance for the internalizing subscale increases just as the introverted anhedonia raises for females, but it decreases when evaluating males. Discussion. It seems clear that no source of data can be substituted for any other when evaluating behavioural problems in adolescents and much less when attention is centred in those adolescents who score high in schizotypy. Specifically, when evaluating the behaviour of those subjects who score high in the positive dimension of schizotypy, the agreement between informants decreases for thought and internalizing problems; and, when the behaviour of those who are defined for a more negative schizotypy is evaluated, the agreement decreases for social problems, anxiety/ depression, externalizing and total. Having all this into account and adding information that other authors have found related to each schizotypy subtype (which, besides, are the ones which more concordance show), some conclusions could be raised. It can be assumed as evident that schizotypical personality (and each trait type) and the subjacent conduct in these subjects can generate a difficulty in perceiving certain conducts which are not predominant in the subject, with the consequent discordance between informants. For future studies, it would be very interesting to carry out studies examined which group of informants augurs the behavioural predisposition for schizophrenia and its dimensions in the most accurately way possible. Conclusions. A most exact and objective method to assess behavioural problems as well-demonstrated predictor to schizophrenia, is necessary in order to select vulnerable teenagers to the illness and to develop programs of early intervention.