Journal article
When parents and children disagree: Informant discrepancies in reports of depressive symptoms in clinical interviews.
- Baumgartner N Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland. Electronic address: noemi.baumgartner@uzh.ch.
- Häberling I Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
- Emery S Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
- Strumberger M Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Switzerland.
- Nalani K Clinic for Psychosomatic Medicine and Psychiatry, Zurich, Switzerland.
- Erb S Child and Adolescent Psychiatric Services St. Gallen, St. Gallen, Switzerland.
- Bachmann S Clienia Littenheid AG, Littenheid, Switzerland; University Clinic of the Martin-Luther University Halle - Wittenberg's Medical Faculty, Switzerland.
- Wöckel L Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Switzerland; Clienia Littenheid AG, Littenheid, Switzerland.
- Müller-Knapp U Child and Adolescent Psychiatry Klinik Sonnenhof, Ganterschwil, Switzerland.
- Rhiner B Child and Adolescent Psychiatry Thurgau, Weinfelden, Switzerland.
- Contin-Waldvogel B Child and Adolescent Psychiatric Services Baselland, Liestal, Switzerland.
- Schmeck K Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Switzerland.
- Walitza S Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Center for Integrative Human Physiology Zurich, University of Zurich, Switzerland.
- Berger G Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
- 2020-06-20
Published in:
- Journal of affective disorders. - 2020
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
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- DOI 10.1016/j.jad.2020.04.008
- PMID 32553362
- Persistent URL
- https://sonar.ch/global/documents/175813
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