Background Diagnostic information for psychiatric research often depends on both clinical interviews and medical records. Although discrepancies between these two sources are well known, there have been few studies into the degree and origins of inconsistencies. Principal findings We compared data from structured interviews and medical records on 1,970 Han Chinese women with recurrent DSM-IV major depression (MD). Correlations were high for age at onset of MD (0.93) and number of episodes (0.70), intermediate for family history (+0.62) and duration of longest episode (+0.43) and variable but generally more modest for individual depressive symptoms (mean kappa = 0.32). Four factors were identified for twelve symptoms from medical records and the same four factors emerged from analysis of structured interviews. Factor congruencies were high but the correlation of factors between interviews and records were modest (i.e. +0.2 to +0.4). Conclusions Structured interviews and medical records are highly concordant for age of onset, and the number and length of episodes, but agree more modestly for individual symptoms and symptom factors. The modesty of these correlations probably arises from multiple factors including i) inconsistency in the definition of the worst episode, ii) inaccuracies in self-report and iii) difficulties in coding medical records where symptoms were recorded solely for clinical purposes.
References
[1]
Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, et al. (1992) The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability. Arch Gen Psychiatry 49: 630–636.
[2]
Leckman JF, Sholomskas D, Thompson WD, Belanger A, Weissman MM (1982) Best estimate of lifetime psychiatric diagnosis: a methodological study. Arch Gen Psychiatry 39: 879–883.
[3]
Bromet EJ, Dunn LO, Connell MM, Dew MA, Schulberg HC (1986) Long-term reliability of diagnosing lifetime major depression in a community sample. Arch Gen Psychiatry 43: 435–440.
[4]
Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ (1993) The lifetime history of major depression in women. Reliability of diagnosis and heritability. Arch Gen Psychiatry 50: 863–870.
[5]
Fendrich M, Weissman MM, Warner V, Mufson L (1990) Two-year recall of lifetime diagnoses in offspring at high and low risk for major depression. The stability of offspring reports. Arch Gen Psychiatry 47: 1121–1127.
[6]
Miller PR, Dasher R, Collins R, Griffiths P, Brown F (2001) Inpatient diagnostic assessments: 1. Accuracy of structured vs. unstructured interviews. Psychiatry Res 105: 255–264.
[7]
Shear MK, Greeno C, Kang J, Ludewig D, Frank E, et al. (2000) Diagnosis of nonpsychotic patients in community clinics. Am J Psychiatry 157: 581–587.
[8]
Fanous AH, Amdur RL, O'Neill FA, Walsh D, Kendler KS (2011) Concordance between chart review and structured interview assessments of schizophrenic symptoms. Compr Psychiatry.
[9]
Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ (1992) Familial influences on the clinical characteristics of major depression: a twin study. Acta Psychiatr Scand 86: 371–378.
[10]
Oquendo MA, Barrera A, Ellis SP, Li S, Burke AK, et al. (2004) Instability of symptoms in recurrent major depression: a prospective study. Am J Psychiatry 161: 255–261.
[11]
Helzer JE, Robins LN, McEvoy LT, Spitznagel EL, Stoltzman RK, et al. (1985) A comparison of clinical and diagnostic interview schedule diagnoses. Physician reexamination of lay-interviewed cases in the general population. Arch Gen Psychiatry 42: 657–666.
[12]
Segal DL, Hersen M, Van Hasselt VB (1994) Reliability of the Structured Clinical Interview for DSM-III-R: an evaluative review. Compr Psychiatry 35: 316–327.
[13]
Helzer JE, Clayton PJ, Pambakian R, Woodruff RA (1978) Concurrent diagnostic validity of a structured psychiatric interview. Arch Gen Psychiatry 35: 849–853.
[14]
Association AP (1994) Diagnostic and statistical manual of mental disorders. Washington, D.C.: American Psychiatric Association.
[15]
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150: 85–100.
[16]
Endicott J, Andreasen N, Spitzer RL (1975) Family History-Research Diagnostic Criteria. New York: Biometrics Research, New York State Psychiatric Institute.
[17]
Cohen J (1960) A coefficient of agreement for nominal scales. Educational and Psychological Measurement 20: 37–46.
