Effects of endogenicity and severity on consistency of standard depression rating scales

Agreement between the clinician-rated Hamilton Depression Rating Scale and the patient-rated Zung Self-Rating Depression Scale was examined in 36 inpatients with major depression during the course of a 4-week antidepressant treatment protocol. Clinician-patient agreement was low when depression was rated as most severe by the clinician. An endogenicity factor extracted from the Zung scale also predicted disagreement, which was greatest for patients with more nonendogenous symptom patterns. Clinicians and researchers should remain aware of the limitations of such standard assessment procedures in the context of changing criteria for the diagnosis of depression.