title: Concordance between Composite International Diagnostic Interview and self-reports of depressive symptoms: a re-analysis.
abstract: Concordance between sum scores of self-reported depressive symptoms and structured interview diagnoses has been studied extensively, but are these the best attainable self-report-based predictions for interview diagnoses? We maximized the cross-validated concordance between World Health Organization's Composite International Diagnostic Interview (CIDI) diagnosis and Beck's Depression Inventory (BDI), and General Health Questionnaire (GHQ), from the viewpoint of exploratory statistics, re-analysing Health 2000 general-population sample of adults over 30 years in mainland Finland (N = 5200-5435). BDI sum-score prediction of CIDI diagnosis could be superseded by using (1) weighted sums of items, (2) classification trees constructed from items, or (3) a single item. Best solution (2) yielded cross-validated Youden's Index 0.757 [standard error (SE) = 0.001, sensitivity = 0.907, specificity = 0.851], improving the concordance to 1.07-fold (1.18-fold for 12-month diagnosis). A single-item solution was best for the GHQ. All positive predictive values remained low (0.09-0.31). Thus, CIDI-to-questionnaire concordance can be improved by using all information in the questionnaires instead of just sum scores, but latent-trait theory for questionnaires is incompatible with interview diagnoses (single item achieved better concordance than summing all). Self-reports have low predictive value for CIDI diagnoses in the general population, but better in settings with higher major depressive disorder (MDD) base rates. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Finland.|National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Tom
authors.initials: T
authors.lastname: Rosenström
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Finland.|National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Jokela
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.|School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Sami
authors.initials: S
authors.lastname: Pirkola
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Olavi
authors.initials: O
authors.lastname: Lindfors
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Keltikangas-Järvinen
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005387:Finland; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Beck's Depression Inventory; General Health Questionnaire; depressive disorder; reliability; validity