Discrepancies between self and observer ratings of depression. The relationship to demographic, clinical and personality variables.
BACKGROUND
The observer-rated Hamilton depression scale (HamD) and the self-report Beck Depression Inventory (BDI) are among the most commonly used rating scales for depression, and both have well demonstrated reliability and validity. However, many depressed subjects have discrepant scores on these two assessment methods. The present study evaluated the ability of demographic, clinical and personality factors to account for the discrepancies observed between BDI and HamD ratings.


METHODS
The study group consisted of 94 SCID-diagnosed outpatients with a current major depressive disorder. Subjects were rated with the 21-item HamD and completed the BDI and the NEO-Five Factor Inventory.


RESULTS
Younger age, higher educational attainment, and depressive subtype (atypical, non-melancholic) were predictive of higher BDI scores relative to HamD observer ratings. In addition, high neuroticism, low extraversion and low agreeableness were associated with higher endorsement of depressive symptoms on the BDI relative to the HamD. In general, these predictive variables showed a greater ability to explain discrepancies between self and observer ratings of psychological symptoms of depression compared to somatic symptoms of depression.


CONCLUSIONS
The study does not determine which aspects of neuroticism and extraversion contribute to the observed BDI/HamD discrepancies.


CONCLUSIONS
Depression ratings obtained with the BDI and HamD are frequently discordant and a number of patient characteristics robustly predict the discrepancy between these two rating methods. The value of multi-modal assessment in the conduct of research on depressive disorders is re-affirmed.
University of Manitoba, Department of Psychiatry, PZ-430 771 Bannatyne Ave., Winnipeg, Manitoba, Canada R3E 3N4. menns@cc.umanitoba.ca
M W
MW
Enns
D K
DK
Larsen
B J
BJ
Cox
D000328:Adult; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010551:Personality; D010555:Personality Inventory / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012649:Self Concept; D012720:Severity of Illness Index