Abstract
BackgroundRespondents’ report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview.MethodsData came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6 weeks (median).Results73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18–29 years (62.6%) and decreased with age (65–79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45–64 years (49.3%) and lowest among those aged 18–29 years (22.7%) and 30–44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression.ConclusionsRespondents’ report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum.
Highlights
Respondents’ report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence
Among participants with a clinician-diagnosed depression, meeting the criteria of major depressive disorder (MDD) was more likely with any other mental disorder present and with current depressive symptoms and the suicide item affirmed in both Patient Health Questionnaire-9 (PHQ-9) assessments (Table 2)
This study contributes to a better understanding of survey results based on the respondent’s report of a clinician-diagnosed depression
Summary
Respondents’ report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. The overlap of the two measures was only moderate, and, in agreement with previous research [2, 4, 9, 10], prevalence of major depression was highest in younger age adults and of clinician-diagnosed depression in middle-aged and older adults [1] These findings suggest that there are substantial differences between DSM-IV-based major depression and a cliniciandiagnosed depression and, as a consequence, that the presence of major depression may not be inferred with accuracy from the respondent’s report of a previous clinician diagnosis. We examine the proportion of mental disorders based on a comprehensive standardized diagnostic research interview among survey participants who report a cliniciandiagnosed depression as a function of sex, age, and depression severity. Socio-demographic, health-related and mental health characteristics are reported separately for survey participants with different combinations of depression diagnoses based on the cross-classification of diagnoses according to a diagnostic interview administered in the survey and the respondents’ reports of being diagnosed by a clinician
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