title: Self-report and clinician-rated measures of depression severity: can one replace the other?
abstract: BACKGROUND
  It has been suggested that clinician-rated scales and self-report questionnaires may be interchangeable in the measurement of depression severity, but it has not been tested whether clinically significant information is lost when assessment is restricted to either clinician-rated or self-report instruments. The aim of this study is to test whether self-report provides information relevant to short-term treatment outcomes that is not captured by clinician-rating and vice versa.
  
  
  METHODS
  In genome-based drugs for depression (GENDEP), 811 patients with major depressive disorder treated with escitalopram or nortriptyline were assessed with the clinician-rated Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Rating Scale for Depression (HRSD), and the self-report Beck Depression Inventory (BDI). In sequenced treatment alternatives to relieve depression (STAR*D), 4,041 patients treated with citalopram were assessed with the clinician-rated and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C and QIDS-SR) in addition to HRSD.
  
  
  RESULTS
  In GENDEP, baseline BDI significantly predicted outcome on MADRS/HRSD after adjusting for baseline MADRS/HRSD, explaining additional 3 to 4% of variation in the clinician-rated outcomes (both P < .001). Likewise, each clinician-rated scale significantly predicted outcome on BDI after adjusting for baseline BDI and explained additional 1% of variance in the self-reported outcome (both P < .001). The results were confirmed in STAR*D, where self-report and clinician-rated versions of the same instrument each uniquely contributed to the prediction of treatment outcome.
  
  
  CONCLUSIONS
  Complete assessment of depression should include both clinician-rated scales and self-reported measures.
authors.affiliation: Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada. rudolf.uher@kcl.ac.uk
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Roy H
authors.initials: RH
authors.lastname: Perlis
authors.forename: Anna
authors.initials: A
authors.lastname: Placentino
authors.forename: Mojca Zvezdana
authors.initials: MZ
authors.lastname: Dernovšek
authors.forename: Neven
authors.initials: N
authors.lastname: Henigsberg
authors.forename: Ole
authors.initials: O
authors.lastname: Mors
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
authors.forename: Anne
authors.initials: A
authors.lastname: Farmer
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use; D015588:Observer Variation; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D057566:Self Report; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D015283:Citalopram; D009661:Nortriptyline