Davies, MR; Buckman, JEJ; Adey, BN; Armour, C; Bradley, JR; Curzons, SCB; Davies, HL; ... Eley, TC; + view all Davies, MR; Buckman, JEJ; Adey, BN; Armour, C; Bradley, JR; Curzons, SCB; Davies, HL; Davis, KAS; Goldsmith, KA; Hirsch, CR; Hotopf, M; Hübel, C; Jones, IR; Kalsi, G; Krebs, G; Lin, Y; Marsh, I; McAtarsney-Kovacs, M; McIntosh, AM; Mundy, J; Monssen, D; Peel, AJ; Rogers, HC; Skelton, M; Smith, DJ; ter Kuile, A; Thompson, KN; Veale, D; Walters, JTR; Zahn, R; Breen, G; Eley, TC; - view fewer (2022) Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts. Journal of Anxiety Disorders , 85 , Article 102491. 10.1016/j.janxdis.2021.102491. (In press).

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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.

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