Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts.

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Publisher: Elsevier B.V.
Document Type: Report
Length: 820 words

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Keywords Anxiety disorders; Measurement; Major depression; Self-report; Online surveys; Phobias Highlights * Symptom-based and self-reported diagnoses are commonly used remote diagnostic measures. * Agreement between the methods was high for any anxiety and MDD cases. * Self-reported diagnoses categorised most participants with anxiety as having GAD. * Symptom-based diagnoses had a more even distribution across the anxiety disorders. * Further validation of these methods against clinical interviews is needed to guide selection. 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. Abbreviations CIDI, Composite International Diagnostic Interview; CIDI-SF, Composite International Diagnostic Interview - short form; SCID, Structured Clinical Interview for DSM-5; MDD, major depressive disorder); GAD, generalised anxiety disorder; DSM-5, Diagnostic Statistical Manual 5; NIHR, National Institute for Health Research; GLAD, Genetic Links to Anxiety and Depression; COPING, COVID-19 Psychiatry and Neurological Genetics; NBR, National Institute for Health Research BioResource; EHR, electronic health records; GP, general practitioner Author Affiliation: (a) Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK (b) National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK (c) Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 7HB, UK (d) iCope -- Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK (e) Stress, Trauma & Related Conditions (STARC) research lab, School of Psychology, Queens University Belfast (QUB), Belfast, Northern Ireland, UK (f) NIHR BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK (g) South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK (h) Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (i) National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark (j) National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK (k) Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK (l) Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK * Correspondence to: Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK. Article History: Received 5 February 2021; Revised 13 October 2021; Accepted 20 October 2021 (footnote)1 Orcid: (footnote)2 Orcid: (footnote)3 Orcid: (footnote)4 Orcid: (footnote)5 Orcid: (footnote)6 Orcid: (footnote)7 Orcid: (footnote)8 Orcid: (footnote)9 Orcid: (footnote)10 Orcid: (footnote)11 Orcid: (footnote)12 Orcid: (footnote)13 Orcid: (footnote)14 Orcid: (footnote)15 Orcid: (footnote)16 Orcid: (footnote)17 Orcid: (footnote)18 Orcid: (footnote)19 Orcid: (footnote)20 Orcid: (footnote)21 Orcid: (footnote)22 Orcid: (footnote)23 Orcid: (footnote)24 Orcid: (footnote)25 Orcid: (footnote)26 Orcid: (footnote)27 Orcid: (footnote)28 Orcid: (footnote)29 Orcid: Byline: Molly R. Davies (a,b,1), Joshua E.J. Buckman (c,d,2), Brett N. Adey (a,b,3), Chérie Armour (e,4), John R. Bradley (f,5), Susannah C.B. Curzons (a,b,6), Helena L. Davies (a,b), Katrina A.S. Davis (a,b,g,7), Kimberley A. Goldsmith (a,b,8), Colette R. Hirsch (a,b,g,9), Matthew Hotopf (a,b,g,10), Christopher Hübel (a,b,h,i,11), Ian R. Jones (j,12), Gursharan Kalsi (a,b,13), Georgina Krebs (a,g,14), Yuhao Lin (a,b,15), Ian Marsh (a,b), Monika McAtarsney-Kovacs (a,b,16), Andrew M. McIntosh (k,17), Jessica Mundy (a,b), Dina Monssen (a,b,18), Alicia J. Peel (a,19), Henry C. Rogers (a,b,20), Megan Skelton (a,b,21), Daniel J. Smith (l,22), Abigail ter Kuile (a,b,23), Katherine N. Thompson (a,b,24), David Veale (a,b,g,25), James T.R. Walters (j,26), Roland Zahn (a,b,27), Gerome Breen (a,b,28), Thalia C. Eley [] (a,b,*,29)

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Gale Document Number: GALE|A689190344