Molly R Davies1, Joshua E J Buckman2, Brett N Adey1, Chérie Armour3, John R Bradley4, Susannah C B Curzons1, Helena L Davies1, Katrina A S Davis5, Kimberley A Goldsmith1, Colette R Hirsch5, Matthew Hotopf5, Christopher Hübel6, Ian R Jones7, Gursharan Kalsi1, Georgina Krebs8, Yuhao Lin1, Ian Marsh1, Monika McAtarsney-Kovacs1, Andrew M McIntosh9, Jessica Mundy1, Dina Monssen1, Alicia J Peel10, Henry C Rogers1, Megan Skelton1, Daniel J Smith11, Abigail Ter Kuile1, Katherine N Thompson1, David Veale5, James T R Walters7, Roland Zahn1, Gerome Breen1, Thalia C Eley12. 1. Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK. 2. Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 7HB, UK; iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK. 3. Stress, Trauma & Related Conditions (STARC) research lab, School of Psychology, Queens University Belfast (QUB), Belfast, Northern Ireland, UK. 4. NIHR BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK. 5. Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK. 6. Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark. 7. National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK. 8. Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK. 9. Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK. 10. Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK. 11. Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. 12. Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK. Electronic address: thalia.eley@kcl.ac.uk.
Abstract
BACKGROUND: Understanding and improving outcomes for people with anxiety or depression often requires large sample sizes. To increase participation and reduce costs, such research is typically unable to utilise "gold-standard" methods to ascertain diagnoses, instead relying on remote, self-report measures. AIMS: Assess the comparability of remote diagnostic methods for anxiety and depression disorders commonly used in research. METHOD: Participants from the UK-based GLAD and COPING NBR cohorts (N = 58,400) completed an online questionnaire between 2018 and 2020. Responses to detailed symptom reports were compared to DSM-5 criteria to generate symptom-based diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), specific phobia, social anxiety disorder, panic disorder, and agoraphobia. Participants also self-reported any prior diagnoses from health professionals, termed self-reported diagnoses. "Any anxiety" included participants with at least one anxiety disorder. Agreement was assessed by calculating accuracy, Cohen's kappa, McNemar's chi-squared, sensitivity, and specificity. RESULTS: Agreement between diagnoses was moderate for MDD, any anxiety, and GAD, but varied by cohort. Agreement was slight to fair for the phobic disorders. Many participants with self-reported GAD did not receive a symptom-based diagnosis. In contrast, symptom-based diagnoses of the phobic disorders were more common than self-reported diagnoses. CONCLUSIONS: Agreement for MDD, any anxiety, and GAD was higher for cases in the case-enriched GLAD cohort and for controls in the general population COPING NBR cohort. For anxiety disorders, self-reported diagnoses classified most participants as having GAD, whereas symptom-based diagnoses distributed participants more evenly across the anxiety disorders. Further validation against gold standard measures is required.
BACKGROUND: Understanding and improving outcomes for people with anxiety or depression often requires large sample sizes. To increase participation and reduce costs, such research is typically unable to utilise "gold-standard" methods to ascertain diagnoses, instead relying on remote, self-report measures. AIMS: Assess the comparability of remote diagnostic methods for anxiety and depression disorders commonly used in research. METHOD: Participants from the UK-based GLAD and COPING NBR cohorts (N = 58,400) completed an online questionnaire between 2018 and 2020. Responses to detailed symptom reports were compared to DSM-5 criteria to generate symptom-based diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), specific phobia, social anxiety disorder, panic disorder, and agoraphobia. Participants also self-reported any prior diagnoses from health professionals, termed self-reported diagnoses. "Any anxiety" included participants with at least one anxiety disorder. Agreement was assessed by calculating accuracy, Cohen's kappa, McNemar's chi-squared, sensitivity, and specificity. RESULTS: Agreement between diagnoses was moderate for MDD, any anxiety, and GAD, but varied by cohort. Agreement was slight to fair for the phobic disorders. Many participants with self-reported GAD did not receive a symptom-based diagnosis. In contrast, symptom-based diagnoses of the phobic disorders were more common than self-reported diagnoses. CONCLUSIONS: Agreement for MDD, any anxiety, and GAD was higher for cases in the case-enriched GLAD cohort and for controls in the general population COPING NBR cohort. For anxiety disorders, self-reported diagnoses classified most participants as having GAD, whereas symptom-based diagnoses distributed participants more evenly across the anxiety disorders. Further validation against gold standard measures is required.
Authors: Roosje Walrave; Simon Gabriël Beerten; Pavlos Mamouris; Kristien Coteur; Marc Van Nuland; Gijs Van Pottelbergh; Lidia Casas; Bert Vaes Journal: BMC Prim Care Date: 2022-06-28
Authors: Antja Watanangura; Sebastian Meller; Jan S Suchodolski; Rachel Pilla; Mohammad R Khattab; Shenja Loderstedt; Lisa F Becker; Andrea Bathen-Nöthen; Gemma Mazzuoli-Weber; Holger A Volk Journal: Front Vet Sci Date: 2022-08-04