Does clinical experience or professional training have an impact on what symptoms are thought to be important features of depression?

BACKGROUND

Concerning diagnostics of mental disorders, increasing time and cost pressure in the clinical practice often requires an ad hoc and intuitive holistic examination of the patient's clinical presentation instead of the application of standardized diagnostic instruments. This study examined whether attributes of mental healthcare professionals (professional training, clinical experience, socio-demographic variables) affect their implicit weighing of symptoms they encounter in such unstandardized diagnostic situations.

METHODS

Twenty psychiatrists and 28 clinical psychologists rated the relevance of 241 items for the diagnosis of a depressive episode. Items referred to the nine A-criteria of DSM-IV and associated features. Intraclass correlations (ICC), regression analysis and t-tests were calculated.

RESULTS

Clinicians agreed largely in their relevance judgements on the different items ( ICC = 0.97, F (183,8784) = 44.29, p < 0.001). Stepwise regression analyses with profession, clinical experience, age and gender as predictors for each DSM-IV A-criterion revealed no significant β-coefficient except for one: 'profession' was a significant predictor for the mean relevance judgement on items that could not be assigned to an A-criterion. This effect turned out to be caused by only one item (obsessive-compulsive behaviour).

CONCLUSIONS

Clinical experts agree highly in their implicit weighing of depression symptoms regardless of their age, gender, clinical experience and professional training.