title: Reliability and validity of the DSM-5 Anxious Distress Specifier Interview.
abstract: To acknowledge the clinical significance of anxiety in depressed patients, DSM-5 included an anxious distress specifier for major depressive disorder (MDD). In the present report we describe the reliability and validity of a semi-structured interview assessing the features of the anxious distress specifier. Our goal was to develop an instrument that could be used for both diagnostic and outcome measurement purposes.
  
  
  
  One hundred seventy-three psychiatric patients with MDD were interviewed by a trained diagnostic rater who administered the Structured Clinical Interview for DSM-IV (SCID) supplemented with questions from the DSM-5 Anxious Distress Specifier Interview (DADSI). Inter-rater (n=25) and test-retest (n=25) reliability of the DADSI was examined in separate groups of patients. The patients were rated on clinician rating scales of depression, anxiety and irritability, and patients completed self-report measures of these constructs. Sensitivity to change was examined in 16 patients.
  
  
  
  Approximately three-quarters of the depressed patients met the criteria for the anxious distress specifier (78.0%, n=135). The DADSI had excellent joint-interview reliability and good test-retest reliability. DADSI total scores were more highly correlated with other clinician-rated and self-report measures of anxiety than with measures of depression and anger. DADSI scores were significantly higher in depressed outpatients with a current anxiety disorder than depressed patients without a comorbid anxiety disorder. The DADSI was sensitive to improvement.
  
  
  
  The DADSI is a reliable and valid measure of the presence of the DSM-5 anxious distress specifier for MDD as well as the severity of the features of the specifier.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA. Electronic address: mzimmerman@lifespan.org.
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Clark
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGonigal
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Harris
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Carolina Guzman
authors.initials: CG
authors.lastname: Holst
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000786:Anger; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000523:psychology; D015203:Reproducibility of Results; D012237:Rhode Island / Q000453:epidemiology; D057566:Self Report; D055815:Young Adult