Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts.
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Davies Molly R, Buckman Joshua E J, Adey Brett N, Armour Chérie, Bradley John R, Curzons Susannah C B, Davies Helena L, Davis Katrina A S, Goldsmith Kimberley A, Hirsch Colette R, Hotopf Matthew, Hübel Christopher, Jones Ian R, Kalsi Gursharan, Krebs Georgina, Lin Yuhao, Marsh Ian, McAtarsney-Kovacs Monika, McIntosh Andrew M, Mundy Jessica, Monssen Dina, Peel Alicia J, Rogers Henry C, Skelton Megan, Smith Daniel J, Ter Kuile Abigail, Thompson Katherine N, Veale David, Walters James T R, Zahn Roland, Breen Gerome, Eley Thalia C
Аннотация
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.