Concordance between self-report and clinician's assessment of depression

Abstract

In order to assess differences between self-assessment and clinician's assessment of depression, 64 depressed in-patients were assessed for depressive symptomatology at admission (D0), 10 days (D10) and 28 days (D28) after the beginning of antidepressant treatment, using the Inventory for Depressive Symptomatology Clinician Rated (IDS-C) and the Inventory for Depressive Symptomatology Self-Rated (IDS-SR). Associated symptoms (SCL-90R) were assessed at D0 and personality dimensions (TCI) at D28. Although agreement was high between IDS-C and IDS-SR total scores, D0, D0-D10 and D0-D28 total scores were significantly different between IDS-C and IDS-SR, showing a higher sensitivity to change for IDS-C as compared to IDS-SR. Differences between IDS-C and IDS-SR were due mostly to mood items and not to somatic items. Discrepancies between self-assessment and clinician's assessment of depressive symptomatology were linked neither to age, sex, familial status, single/recurrent and length of episode, nor to depression severity, but to associated symptoms and, to a lesser extent, personality dimensions: patients over-estimating their depressive symptomatology change relative to the psychiatrist tended to score high on phobic anxiety, Cooperativeness (especially Social Acceptance) and Self-Transcendence (especially Self-forgetfulness) and vice-versa.