Comparison between self-administered depression questionnaires and patients' own views of changes in their mood: a prospective cohort study in primary care

Catherine Hobbs, Gemma Lewis, Christopher Dowrick, Daphne Kounali, Tim J Peters, Glyn Lewis

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

BACKGROUND: Self-administered questionnaires are widely used in primary care and other clinical settings to assess the severity of depressive symptoms and monitor treatment outcomes. Qualitative studies have found that changes in questionnaire scores might not fully capture patients' experience of changes in their mood but there are no quantitative studies of this issue. We examined the extent to which changes in scores from depression questionnaires disagreed with primary care patients' perceptions of changes in their mood and investigated factors influencing this relationship.

METHODS: Prospective cohort study assessing patients on four occasions, 2 weeks apart. Patients (N = 554) were recruited from primary care surgeries in three UK sites (Bristol, Liverpool and York) and had reported depressive symptoms or low mood in the past year [68% female, mean age 48.3 (s.d. 12.6)]. Main outcome measures were changes in scores on patient health questionnaire (PHQ-9) and beck depression inventory (BDI-II) and the patients' own ratings of change.

RESULTS: There was marked disagreement between clinically important changes in questionnaire scores and patient-rated change, with disagreement of 51% (95% CI 46-55%) on PHQ-9 and 55% (95% CI 51-60%) on BDI-II. Patients with more severe anxiety were less likely, and those with better mental and physical health-related quality of life were more likely, to report feeling better, having controlled for depression scores.

CONCLUSIONS: Our results illustrate the limitations of self-reported depression scales to assess clinical change. Clinicians should be cautious in interpreting changes in questionnaire scores without further clinical assessment.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalPsychological Medicine
Early online date20 Jan 2020
DOIs
Publication statusE-pub ahead of print - 20 Jan 2020

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