title: Respondents' report of a clinician-diagnosed depression in health surveys: comparison with DSM-IV mental disorders in the general adult population in Germany.
abstract: Respondents' report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview.
  
  
  
  Data came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6 weeks (median).
  
  
  
  73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18-29 years (62.6%) and decreased with age (65-79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45-64 years (49.3%) and lowest among those aged 18-29 years (22.7%) and 30-44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression.
  
  
  
  Respondents' report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum.
authors.affiliation: Department of Epidemiology and Health Monitoring, Division 26 Mental Health, Robert Koch Institute, Berlin, Germany.
authors.forename: Ulrike E
authors.initials: UE
authors.lastname: Maske
authors.affiliation: Department of Epidemiology and Health Monitoring, Division 26 Mental Health, Robert Koch Institute, Berlin, Germany. FG26-psychische-Gesundheit@rki.de.
authors.forename: Ulfert
authors.initials: U
authors.lastname: Hapke
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.affiliation: Department of Epidemiology and Health Monitoring, Division 26 Mental Health, Robert Koch Institute, Berlin, Germany.
authors.forename: Markus A
authors.initials: MA
authors.lastname: Busch
authors.affiliation: Department of Health Care Policy, Harvard University, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Composite International Diagnostic Interview; Depression; Diagnosis; General population; Health surveys