DSM-IV Major Depressive Episode criteria: An evaluation of reliability and validity across three different rating methods

Abstract

This study examined the reliability and validity of the DSM-IV Major Depressive Episode (MDE) symptoms in a sample of outpatients based on clinician ratings of assessment interviews, videotape of these interviews, and chart information. A group of 44 patients admitted to a university based outpatient community clinic were rated by trained clinicians on the nine MDE symptom criteria (A1-A9). Patients also completed a self-report measure of depressive symptomatology. Interrater reliability was found to be highest between the interview and videotape ratings. Conversely, when comparing chart ratings with those made from either interview or videotape, reliability for many of the individual criteria were found to be in the poor range of reliability. Good internal consistency was found for both the interview and videotape ratings, while internal consistency was less adequate for chart-based ratings. However, the three MDE ratings converge on a single dimension in a similar manner regardless of which source (i.e. interview, videotape, or chart) provided the rating. Additional analyses revealed a consistent relationship between the three MDE ratings (interview, videotape, and chart) with measures of patient reported depressive symptoms that exceeded the relationship between these scores with global levels/severity of psychopathology. The effects of longer interviews as well as examining depressive symptoms within the context of interpersonal functioning is discussed regarding the reliable assessment of depressive symptomatology in the mild to moderate range of severity. (Int J Psych Can Pract 2004; 8: 3–10)