The relationship of self-reported distress to depressive disorders and other psychopathology

J Consult Clin Psychol. 1994 Jun;62(3):550-9. doi: 10.1037//0022-006x.62.3.550.


The relationship between self-reported depression and a clinical diagnosis of depression was investigated. Within 2 weeks of completing the Center for Epidemiologic Studies Depression Scale (CES-D), a stratified sample of 425 primary medical care patients received the structured interview for the DSM-III-R. In the weighted data set, the CES-D was significantly related to a diagnosis of depression but also to other Axis I disorders. Most distressed subjects were not depressed, a fifth of the patients with major depressive disorder (MDD) had low distress, and the CES-D performed as well in detecting anxiety as in detecting depression. MDD, other depression diagnoses, and anxiety and substance use disorders were all significant predictors of CES-D score. Differences in demographic variables, treatment history, and impairment highlight the nonequivalence of the self-report scale and diagnosable depression. The use of a self-report in place of an interview-based diagnostic measure in the study of depression, as well as the use of such a report as a screening device, is discussed.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team*
  • Personality Assessment / statistics & numerical data
  • Personality Inventory / statistics & numerical data*
  • Primary Health Care
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Reproducibility of Results