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When parents and children disagree: Informant discrepancies in reports of depressive symptoms in clinical interviews


Baumgartner, Noemi; Häberling, Isabelle; Emery, Sophie; Strumberger, Michael; Nalani, Kristin; Erb, Suzanne; Bachmann, Silke; Wöckel, Lars; Müller-Knapp, Ulrich; Rhiner, Bruno; Contin-Waldvogel, Brigitte; Schmeck, Klaus; Walitza, Susanne; Berger, Gregor (2020). When parents and children disagree: Informant discrepancies in reports of depressive symptoms in clinical interviews. Journal of Affective Disorders, 272:223-230.

Abstract

BACKGROUND: Parents and their children often disagree on the existence and severity of psychopathological symptoms, especially in major depressive disorder (MDD). Discrepant estimations pose a problem for the validity of diagnoses and illness severity with major implications for treatment evaluation.
METHODS: 118 adolescents aged 13-18 years and their parents were interviewed and their reports were compared regarding the presence of a MDD diagnosis. In addition, severity ratings of depression symptoms reported in the Children's Depression Rating Scale-Revised (CDRS-R) were compared between parents and their offspring using multivariate analyses and polynomial regressions. The association between borderline features, functional impairment, and treatment history variables with parent-child agreement was assessed.
RESULTS: In 38% of the cases, parents and adolescents agreed on DSM-IV diagnostic MDD criteria, while in 53%, only the adolescent endorsed criteria for a MDD. A MDD that was endorsed by parents and adolescents was characterized by higher depression severity, higher number of previous treatments, and higher functional impairment. Using a polynomial approach, neither age nor borderline tendencies were associated with agreement.
LIMITATIONS: We did not differentiate between mother's versus father's reports and borderline features were assessed by self-report only.
CONCLUSIONS: Adolescents and their parents gave differing reports of the existence and severity of depressive symptoms. The high discrepancy levels combined with the uncertainty of previously published findings due to methodological challenges are concerning. Clinicians and researchers need to consider discrepancies in agreement in relation to diagnosis and illness severity in the context of their clinical and research decisions.

Abstract

BACKGROUND: Parents and their children often disagree on the existence and severity of psychopathological symptoms, especially in major depressive disorder (MDD). Discrepant estimations pose a problem for the validity of diagnoses and illness severity with major implications for treatment evaluation.
METHODS: 118 adolescents aged 13-18 years and their parents were interviewed and their reports were compared regarding the presence of a MDD diagnosis. In addition, severity ratings of depression symptoms reported in the Children's Depression Rating Scale-Revised (CDRS-R) were compared between parents and their offspring using multivariate analyses and polynomial regressions. The association between borderline features, functional impairment, and treatment history variables with parent-child agreement was assessed.
RESULTS: In 38% of the cases, parents and adolescents agreed on DSM-IV diagnostic MDD criteria, while in 53%, only the adolescent endorsed criteria for a MDD. A MDD that was endorsed by parents and adolescents was characterized by higher depression severity, higher number of previous treatments, and higher functional impairment. Using a polynomial approach, neither age nor borderline tendencies were associated with agreement.
LIMITATIONS: We did not differentiate between mother's versus father's reports and borderline features were assessed by self-report only.
CONCLUSIONS: Adolescents and their parents gave differing reports of the existence and severity of depressive symptoms. The high discrepancy levels combined with the uncertainty of previously published findings due to methodological challenges are concerning. Clinicians and researchers need to consider discrepancies in agreement in relation to diagnosis and illness severity in the context of their clinical and research decisions.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Department of Child and Adolescent Psychiatry
04 Faculty of Medicine > Neuroscience Center Zurich
04 Faculty of Medicine > Center for Integrative Human Physiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Social Sciences & Humanities > Clinical Psychology
Health Sciences > Psychiatry and Mental Health
Language:English
Date:1 July 2020
Deposited On:02 Jul 2020 14:54
Last Modified:29 Jul 2020 15:21
Publisher:Elsevier
ISSN:0165-0327
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.jad.2020.04.008
PubMed ID:32553362

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