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Discrepancy between Clinician-rated and Self-reported Depression Severity is Associated with Adverse Childhood

Risa Yamada1,2,3, Takeshi Fujii2,4, Kotaro Hattori5,6

  • 1Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology
|April 29, 2023
PubMed

Insights

Patients with adverse childhood experiences, autistic traits, and self-blame coping styles may perceive depression severity differently than clinicians. Subjective assessments are crucial for evaluating depressive symptoms in these individuals.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Science

Background:

  • Discrepancies exist between patient-reported and clinician-rated depression severity in mood disorders.
  • Understanding the factors influencing this discrepancy is vital for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate if behavioral/psychological features influence the difference between clinician-rated (Hamilton Depression Rating Scale - HAMD) and patient-reported (Beck Depression Inventory - BDI) depression severity.
  • To identify specific patient characteristics associated with over- or under-reporting of depression.

Main Methods:

  • 100 mood disorder patients were assessed using HAMD and BDI.
  • Participants were grouped based on BDI vs. HAMD ratings: over-rating (BO), concordant (BC), or under-rating (BU).
  • Evaluated adverse childhood experiences (CTQ-6), autistic-like traits (SRS-A), and coping styles (WCCL).

Main Results:

  • Significant correlation found between HAMD and BDI scores.
  • The BO group showed higher scores for adverse childhood experiences (emotional abuse) and self-blame coping styles compared to the BU group.
  • The BO group also exhibited significantly higher autistic-like traits (SRS-A total scores).

Conclusions:

  • Patients with adverse emotional experiences, autistic-like traits, and self-blame coping styles tend to perceive greater depression severity than clinicians objectively evaluate.
  • These findings highlight the importance of incorporating subjective patient assessments alongside objective clinical evaluations for a comprehensive understanding of depressive symptoms.
  • Tailoring treatment approaches to address these psycho-behavioral concerns may improve patient outcomes.
Abstract

Keywords:
Adverse childhood experiencesAutistic disorderCoping behaviorDepressionMood disordersSelf report

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