Clinical Psychopharmacology and Neuroscience Papers in Press available online.

 
Discrepancy between clinician-rated and self-reported depression severity is associated with adverse childhood experience, autistic-like traits, and coping styles in mood disorders
Risa Yamada 1,2,3, Takeshi Fujii 2,4, Kotaro Hattori 5,6, Hiroaki Hori 7, Ryo Matsumura 5, Tomoko Kurashimo 4,5, Naoko Ishihara 4,5, Sumiko Yoshida 4,5,8, Tomiki Sumiyoshi 1,2,4, Hiroshi Kunugi 5,6,9,*
1Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan, 2Department of Psychiatry, National Center Hospital of Neurology and Psychiatry, Tokyo 187-8551, Japan, 3Department of Psychiatry, Jikei University School of Medicine, Tokyo 105-8461, Japan, 4Mood Disorder Center for Advanced Therapy, National Center Hospital of Neurology and Psychiatry, Tokyo 187-8551, Japan, 5Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan, 6Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo 187-8502, Japan, 7Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan, 8Department of Psychiatric Rehabilitation, National Center Hospital of Neurology and Psychiatry, Tokyo 187-8551, Japan, 9Department of Psychiatry, Teikyo University School of Medicine, Tokyo 173-8605, Japan
Abstract
Objective: This study aimed to determine if the discrepancy between depression severity rated by clinicians and that reported by patients depends on key behavioral/psychological features in patients with mood disorders.
Methods: Participants included 100 patients with mood disorders. First, we examined correlations and regressions between scores on the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI). Second, we divided the participants into those who provided 1) greater ratings for the BDI compared with the HAMD (BDI relative-overrating, BO) group, 2) comparable ratings for the BDI and HAMD (BDI relatively concordant, BC) group, or 3) less ratings for the BDI (BDI relative-underrating, BU) group. Adverse childhood experiences, autistic-like traits, and coping styles were evaluated with a six-item short version of the Childhood Trauma Questionnaire (CTQ-6), the Social Responsiveness Scale for Adults (SRS-A), and the Ways of Coping Checklist (WCCL), respectively.
Results: A significant correlation was found between HAMD and BDI scores. Total and emotional abuse subscale scores from the CTQ-6, and the self-blame subscale scores from the WCCL were significantly higher for the BO group compared with the BU group. The BO group also elicited significantly higher SRS-A total scores than did the other groups.
Conclusions: These findings suggest that patients with emotion-focused coping styles, autistic-like traits, and adverse emotional experiences perceive greater distress than that evaluated objectively by clinicians. The results indicate the need for inclusion of subjective assessments to effectively evaluate depressive symptoms in patients deemed to have these psycho-behavioral concerns.
Accepted Manuscript [Submitted on 2021-12-15, Accepted on 2022-02-10]