When parents and children disagree: Informant discrepancies in reports of depressive symptoms in clinical interviews.
Borderline features
Clinical interview
Major depressive disorder
Parent-child agreement
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 07 2020
01 07 2020
Historique:
received:
07
10
2019
revised:
06
02
2020
accepted:
15
04
2020
entrez:
20
6
2020
pubmed:
20
6
2020
medline:
16
2
2021
Statut:
ppublish
Résumé
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. 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. 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. We did not differentiate between mother's versus father's reports and borderline features were assessed by self-report only. 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.
Sections du résumé
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.
Identifiants
pubmed: 32553362
pii: S0165-0327(19)32665-5
doi: 10.1016/j.jad.2020.04.008
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
223-230Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest SW has received royalities from Thieme Hogrefe, Kohlhammer, Springer, and Beltz in the last 5 years. SW has received lecture honoraria from Opopharma in the last 5 years. Her work was supported in the last 5 years by the Swiss National Science Foundation (SNF), diff. EU FP7s, HSM Hochspezialisierte Medizin of the Kanton Zurich, Switzerland, Bfarm Germany, ZInEP, Hartmann Müller Stiftung, Olga Mayenfisch, and Gertrud Thalmann Fonds. KS has received royalities from Springer, Hogrefe, and Schattauer in the last five years. Since 2014, KS received no honoraria from pharmaceutical or other industrial companies. His work was supported in the last five years by the Swiss National Science Foundation (SNF), Swiss Ministry of Justice, University of St. Gallen, Botnar Foundation, and Gertrud Thalmann Fonds. GB was supported by the Swiss National Science Foundation, the Stanley Foundation, the Gertrud Thalmann Fonds, and the Ebnet Foundation and has received lecture honoraria from Lundbeck, Opopharma, Antistress AG (Burgerstein) in the last 5 years. Other authors declare no conflict of interest.