OBJECTIVES: Compare patient- and caregiver-reported outcomes on 25 objective questions contained within the 51-item Schizophrenia Outcomes Assessment Project (SOAP-51) quality of life survey. METHODS: In total, 1500 community-residing individuals with schizophrenia in five states (Massachusetts, South Carolina, Wisconsin, Arizona, Washington) completed SOAP-51 survey at baseline and weeks 4, 5, and 12. Previously, factor analysis indicated SOAP-51 had eight factors (satisfaction, self concept, work/role, mental health, interpersonal, medication effects, activities of daily living, and physical function) with Cronbach alphas ranging from 0.728-0.937 and test/retest intraclass correlations > 0.70 for all but one factor. An expert panel identified 25 SOAP items that could be objectively measured. This 25-item subset was given to each patient's primary caregiver concurrent with each patient's SOAP-51 administration. Caregivers were asked to answer each item in two ways: 1) What is your objective response?, and 2) What do you think is the patient's response? Three correlation sets were performed for week four responses: a) caregiver's objective responses compared to caregiver's estimation of patient's responses (Correlation A), b) caregiver's objective response compared to patient's responses (Correlation B); and caregiver's estimation of patient's responses compared to patient's responses (Correlation C). RESULTS: Strongest correlations occurred in Correlation A [factor scores for caregiver's objective responses compared to caregiver's estimation of patient's responses (0.534-0.862)]; lowest for Correlation B [caregiver's objective response compared to patient's responses (-0.292-0.367)]; and intermediate for Correlation C [caregiver's estimation of patient's responses compared to patient's responses (-0.353-0.564)]. Physical function factor correlations were the strongest in Correlation A (0.862), but the lowest in Correlation B (-0.292) and C (-0.353). CONCLUSIONS: Caregiver objective assessments of individuals with schizophrenia can vary markedly from patient-reported outcomes, but asking caregivers to view the world through the eyes of the patient closes this gap. Asking caregivers to assume a patient's perspective may improve patient-caregiver communications.