The relationship of self-reported distress to depressive disorders and other psychopathology.
The relationship between self-reported depression and a clinical diagnosis of depression was investigated. Within 2 weeks of completing the Center for Epidemiologic Studies Depression Scale (CES-D), a stratified sample of 425 primary medical care patients received the structured interview for the DSM-III-R. In the weighted data set, the CES-D was significantly related to a diagnosis of depression but also to other Axis I disorders. Most distressed subjects were not depressed, a fifth of the patients with major depressive disorder (MDD) had low distress, and the CES-D performed as well in detecting anxiety as in detecting depression. MDD, other depression diagnoses, and anxiety and substance use disorders were all significant predictors of CES-D score. Differences in demographic variables, treatment history, and impairment highlight the nonequivalence of the self-report scale and diagnosable depression. The use of a self-report in place of an interview-based diagnostic measure in the study of depression, as well as the use of such a report as a screening device, is discussed.
Fechner-Bates
S
S
Department of Family Practice, University of Michigan Medical Center, Ann Arbor 48109-0708.
Coyne
J C
JC
Schwenk
T L
TL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D015203:Reproducibility of Results