Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I).
BACKGROUND
Depression assessment in population studies is usually based on depressive symptoms scales. However, the use of scales could lead to the choice of an arbitrary cut-off point depending on the sample characteristics and on the patient diagnosis. Thus, the use of a medical diagnosis of depression could be a more appropriate approach.


OBJECTIVE
To validate a self-reported physician diagnosis of depression using the Structured Clinical Interview for DSM-IV (SCID-I) as Gold Standard and to assess the factors associated to a valid self-reported diagnosis.


METHODS
The SUN Project is a cohort study based on university graduates followed-up through postal questionnaires. The response to the question included in the questionnaire: Have you ever been diagnosed of depression by a physician? was compared to that obtained through the SCID-I applied by a psychiatrist or a clinical psychologist. The percentages of confirmed depression and non-depression were assessed for the overall sample and according to several characteristics. Logistic regression models were fitted to ascertain the association between different factors and a correct classification regarding depression status.


RESULTS
The percentage of confirmed depression was 74.2%; 95% confidence interval (95% CI) = 63.3-85.1. Out of 42 participants who did not report a depression diagnosis in the questionnaire, 34 were free of the disease (%confirmed non-depression = 81.1%; 95% CI = 69.1-92.9). The probability of being a true positive was higher among ex-smokers and non-smokers and among those overweight or obese but the differences were not statistically significant.


CONCLUSIONS
The validity of a self-reported diagnosis of depression in the SUN cohort is adequate. Thus, this question about depression diagnosis could be used in further investigations regarding this disease in this graduate cohort study.
Department of Clinical Sciencies, University of Las Palmas de Gran Canaria, Spain. asanchez@dcc.ulpgc.es
Almudena
A
Sanchez-Villegas
Javier
J
Schlatter
Felipe
F
Ortuno
Francisca
F
Lahortiga
Jorge
J
Pla
Silvia
S
Benito
Miguel A
MA
Martinez-Gonzalez
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires