Discordance of self ratings versus observer ratings in the improvement of depression: role of locus of control and aggressive behavior.

Depression is mainly a subjective experience. Its severity is not always assessed in the same way by patients and clinicians. Divergences between self- and hetero-evaluation of depressive symptoms and severity are also dependent on the cognitive style of a patient. A high proportion of patients judged improved by their physicians continue to declare that serious symptoms are present. These patients tend to use a cognitive style that has been called external locus of control. Some investigators have correlated the locus of control in depressive patients with hostile traits, pointing out that the severity of symptomatology seems to be associated with some forms of hostility, with an external cognitive mode representing particular communications from patients to their caregiver. The present clinical study shows the influence of cognitive style and aggressive behavior on the discordance seen between self- and hetero-evaluation for depression during the improvement of depression.