Respondents' report of a clinician-diagnosed depression in health surveys: Comparison with DSM-IV mental disorders in the general adult population in Germany

Abstract

Background: Respondents' report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview. Methods: Data came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6weeks (median). Results: 73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18-29 years (62.6%) and decreased with age (65-79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45-64 years (49.3%) and lowest among those aged 18-29 years (22.7%) and 30-44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression. Conclusions: Respondents' report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum.