OBJECTIVE: In order to inform outcomes assessments in personalized medicine research, we evaluated the level of agreement between self-reported (SR) and clinician-rated (CR) measures of depression severity before and after treatment with an antidepressant medication. METHODS: We pooled data from three trials (totaling 2075 patients) assessing the efficacy of antidepressant monotherapy in major depressive disorder. Differences between CR (17-item Hamilton Rating Scale for Depression [HAM-D17]) and SR (30-item Inventory of Depressive Symptomatology-Self-Rated) scale scores were used to determine concordance between CR-SR ratings. The effect of anxiety (HAMD17 anxiety-somatization subscale score ≥7) on SR-CR agreement was also assessed. RESULTS: The CR-SR scale agreement was good for response (κ = 0.64) and moderate for remission (κ = 0.57). Patients who rated their depression as less severe than the clinician were significantly more likely to respond to treatment than over-reporters (odds ratio = 1.62; 95% confidence interval: 1.17-2.25). Although anxiety did not impact the level of agreement, among patients with SR-CR discordance, high anxiety was associated with over-reporting of depression severity. CONCLUSION: The levels of disagreement for response and remission were too high for CR and SR scales to be considered interchangeable for research on patient-level outcomes. Anxiety does not meaningfully impact SR-CR agreement.
OBJECTIVE: In order to inform outcomes assessments in personalized medicine research, we evaluated the level of agreement between self-reported (SR) and clinician-rated (CR) measures of depression severity before and after treatment with an antidepressant medication. METHODS: We pooled data from three trials (totaling 2075 patients) assessing the efficacy of antidepressant monotherapy in major depressive disorder. Differences between CR (17-item Hamilton Rating Scale for Depression [HAM-D17]) and SR (30-item Inventory of Depressive Symptomatology-Self-Rated) scale scores were used to determine concordance between CR-SR ratings. The effect of anxiety (HAMD17 anxiety-somatization subscale score ≥7) on SR-CR agreement was also assessed. RESULTS: The CR-SR scale agreement was good for response (κ = 0.64) and moderate for remission (κ = 0.57). Patients who rated their depression as less severe than the clinician were significantly more likely to respond to treatment than over-reporters (odds ratio = 1.62; 95% confidence interval: 1.17-2.25). Although anxiety did not impact the level of agreement, among patients with SR-CR discordance, high anxiety was associated with over-reporting of depression severity. CONCLUSION: The levels of disagreement for response and remission were too high for CR and SR scales to be considered interchangeable for research on patient-level outcomes. Anxiety does not meaningfully impact SR-CR agreement.
Authors: Boadie W Dunlop; Steven P Cole; Charles B Nemeroff; Helen S Mayberg; W Edward Craighead Journal: J Affect Disord Date: 2017-12-27 Impact factor: 4.839
Authors: Jeffrey R Vittengl; Robin B Jarrett; Erica Weitz; Steven D Hollon; Jos Twisk; Ioana Cristea; Daniel David; Robert J DeRubeis; Sona Dimidjian; Boadie W Dunlop; Mahbobeh Faramarzi; Ulrich Hegerl; Sidney H Kennedy; Farzan Kheirkhah; Roland Mergl; Jeanne Miranda; David C Mohr; A John Rush; Zindel V Segal; Juned Siddique; Anne D Simons; Pim Cuijpers Journal: Am J Psychiatry Date: 2016-02-12 Impact factor: 18.112
Authors: Rachel Hershenberg; William M McDonald; Andrea Crowell; Patricio Riva-Posse; W Edward Craighead; Helen S Mayberg; Boadie W Dunlop Journal: J Affect Disord Date: 2020-01-22 Impact factor: 4.839