Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts

Molly R Davies; Joshua E J Buckman; Brett N Adey; Chérie Armour; John R Bradley; Susannah C B Curzons; Helena L Davies; Katrina A S Davis; Kimberley A Goldsmith; Colette R Hirsch; Matthew Hotopf; Christopher Hübel; Ian R Jones; Gursharan Kalsi; Georgina Krebs; Yuhao Lin; Ian Marsh; Monika McAtarsney-Kovacs; Andrew M McIntosh; Jessica Mundy; Dina Monssen; Alicia J Peel; Henry C Rogers; Megan Skelton; Daniel J Smith; Abigail Ter Kuile; Katherine N Thompson; David Veale; James T R Walters; Roland Zahn; Gerome Breen; Thalia C Eley

doi:10.1016/j.janxdis.2021.102491

Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts

J Anxiety Disord. 2022 Jan:85:102491. doi: 10.1016/j.janxdis.2021.102491. Epub 2021 Oct 26.

Authors

Molly R Davies¹, Joshua E J Buckman², Brett N Adey¹, Chérie Armour³, John R Bradley⁴, Susannah C B Curzons¹, Helena L Davies¹, Katrina A S Davis⁵, Kimberley A Goldsmith¹, Colette R Hirsch⁵, Matthew Hotopf⁵, Christopher Hübel⁶, Ian R Jones⁷, Gursharan Kalsi¹, Georgina Krebs⁸, Yuhao Lin¹, Ian Marsh¹, Monika McAtarsney-Kovacs¹, Andrew M McIntosh⁹, Jessica Mundy¹, Dina Monssen¹, Alicia J Peel¹⁰, Henry C Rogers¹, Megan Skelton¹, Daniel J Smith¹¹, Abigail Ter Kuile¹, Katherine N Thompson¹, David Veale⁵, James T R Walters⁷, Roland Zahn¹, Gerome Breen¹, Thalia C Eley¹²

Affiliations

¹ Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK.
² Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 7HB, UK; iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK.
³ Stress, Trauma & Related Conditions (STARC) research lab, School of Psychology, Queens University Belfast (QUB), Belfast, Northern Ireland, UK.
⁴ NIHR BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK.
⁵ Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
⁶ Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark.
⁷ National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK.
⁸ Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
⁹ Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK.
¹⁰ Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK.
¹¹ Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
¹² Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK. Electronic address: thalia.eley@kcl.ac.uk.

PMID: 34775166
DOI: 10.1016/j.janxdis.2021.102491

Abstract

Background: Understanding and improving outcomes for people with anxiety or depression often requires large sample sizes. To increase participation and reduce costs, such research is typically unable to utilise "gold-standard" methods to ascertain diagnoses, instead relying on remote, self-report measures.

Aims: Assess the comparability of remote diagnostic methods for anxiety and depression disorders commonly used in research.

Method: Participants from the UK-based GLAD and COPING NBR cohorts (N = 58,400) completed an online questionnaire between 2018 and 2020. Responses to detailed symptom reports were compared to DSM-5 criteria to generate symptom-based diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), specific phobia, social anxiety disorder, panic disorder, and agoraphobia. Participants also self-reported any prior diagnoses from health professionals, termed self-reported diagnoses. "Any anxiety" included participants with at least one anxiety disorder. Agreement was assessed by calculating accuracy, Cohen's kappa, McNemar's chi-squared, sensitivity, and specificity.

Results: Agreement between diagnoses was moderate for MDD, any anxiety, and GAD, but varied by cohort. Agreement was slight to fair for the phobic disorders. Many participants with self-reported GAD did not receive a symptom-based diagnosis. In contrast, symptom-based diagnoses of the phobic disorders were more common than self-reported diagnoses.

Conclusions: Agreement for MDD, any anxiety, and GAD was higher for cases in the case-enriched GLAD cohort and for controls in the general population COPING NBR cohort. For anxiety disorders, self-reported diagnoses classified most participants as having GAD, whereas symptom-based diagnoses distributed participants more evenly across the anxiety disorders. Further validation against gold standard measures is required.

Keywords: Anxiety disorders; Major depression; Measurement; Online surveys; Phobias; Self-report.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adaptation, Psychological
Anxiety
Anxiety Disorders / diagnosis
Anxiety Disorders / epidemiology
Depression
Depressive Disorder, Major* / epidemiology
Humans
Self Report

Abstract

Publication types

MeSH terms

Grants and funding