Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts

Molly R Davies; Joshua E J Buckman; Brett N Adey; Chérie Armour; John R Bradley; Susannah C B Curzons; Helena L Davies; Katrina A S Davis; Kimberley A Goldsmith; Colette R Hirsch; Matthew Hotopf; Christopher Hübel; Ian R Jones; Gursharan Kalsi; Georgina Krebs; Yuhao Lin; Ian Marsh; Monika McAtarsney-Kovacs; Andrew M McIntosh; Jessica Mundy; Dina Monssen; Alicia J Peel; Henry C Rogers; Megan Skelton; Daniel J Smith; Abigail Ter Kuile; Katherine N Thompson; David Veale; James T R Walters; Roland Zahn; Gerome Breen; Thalia C Eley

doi:10.1016/j.janxdis.2021.102491

Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts

Molly R Davies, Joshua E J Buckman, Brett N Adey, Chérie Armour, John R Bradley, Susannah C B Curzons, Helena L Davies, Katrina A S Davis, Kimberley A Goldsmith, Colette R Hirsch, Matthew Hotopf, Christopher Hübel, Ian R Jones, Gursharan Kalsi, Georgina Krebs, Yuhao Lin, Ian Marsh, Monika McAtarsney-Kovacs, Andrew M McIntosh, Jessica MundyDina Monssen, Alicia J Peel, Henry C Rogers, Megan Skelton, Daniel J Smith, Abigail Ter Kuile, Katherine N Thompson, David Veale, James T R Walters, Roland Zahn, Gerome Breen, Thalia C Eley

Research output: Contribution to journal › Article › peer-review

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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.

Original language	English
Article number	102491
Journal	Journal of Anxiety Disorders
Volume	85
Early online date	26 Oct 2021
DOIs	https://doi.org/10.1016/j.janxdis.2021.102491
Publication status	Published - Jan 2022

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10.1016/j.janxdis.2021.102491

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Davies, M. R., Buckman, J. E. J., Adey, B. N., Armour, C., Bradley, J. R., Curzons, S. C. B., Davies, H. L., Davis, K. A. S., Goldsmith, K. A., Hirsch, C. R., Hotopf, M., Hübel, C., Jones, I. R., Kalsi, G., Krebs, G., Lin, Y., Marsh, I., McAtarsney-Kovacs, M., McIntosh, A. M., ... Eley, T. C. (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. https://doi.org/10.1016/j.janxdis.2021.102491

@article{5327b52f33874e8fb565361331179395,

title = "Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts",

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.",

author = "Davies, {Molly R} and Buckman, {Joshua E J} and Adey, {Brett N} and Ch{\'e}rie Armour and Bradley, {John R} and Curzons, {Susannah C B} and Davies, {Helena L} and Davis, {Katrina A S} and Goldsmith, {Kimberley A} and Hirsch, {Colette R} and Matthew Hotopf and Christopher H{\"u}bel and Jones, {Ian R} and Gursharan Kalsi and Georgina Krebs and Yuhao Lin and Ian Marsh and Monika McAtarsney-Kovacs and McIntosh, {Andrew M} and Jessica Mundy and Dina Monssen and Peel, {Alicia J} and Rogers, {Henry C} and Megan Skelton and Smith, {Daniel J} and {Ter Kuile}, Abigail and Thompson, {Katherine N} and David Veale and Walters, {James T R} and Roland Zahn and Gerome Breen and Eley, {Thalia C}",

note = "Funding Information: We thank the GLAD Study and NIHR BioResource volunteers for their participation, and gratefully acknowledge the NIHR BioResource centres, NHS Trusts and staff for their contribution. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. This study presents independent research funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Further information can be found at http://brc.slam.nhs.uk/about/core-facilities/bioresource . The views expressed are those of the authors and not necessarily those of the NHS, NIHR, HSC R&D Division, Department of Health and Social Care. Funding Information: This work was supported by the National Institute for Health Research (NIHR) BioResource [RG94028, RG85445], National Institute for Health Research (NIHR) Biomedical Research Centre [IS-BRC-1215-20018], Health and Social Care Research and Development (HSC R&D) Division, Public Health Agency [COM/5516/18], Medical Research Council (MRC) Mental Health Data Pathfinder Award (MC_PC_17,217), and the National Centre for Mental Health funding through Health and Care Research Wales. Profs Eley and Breen are part-funded by a program grant from the UK Medical Research Council (MR/V012878/1). Dr Buckman was supported by a Clinical Research Fellowship from the Wellcome Trust (201292/Z/16/Z). Dr. Goldsmith receives funding from the National Institute for Health Research (NIHR), Medical Research Council (MRC), National Institutes of Health (NIH), and the Juvenile Diabetes Research Foundation (JDRF). Dr Krebs is funded by a Clinical Research Training Fellowship from the Medical Research Council (MR/N001400/1). Dr H?bel acknowledges funding from Lundbeckfonden (R276-2018-4581). Funding Information: This work was supported by the National Institute for Health Research ( NIHR ) BioResource [ RG94028 , RG85445 ], National Institute for Health Research (NIHR) Biomedical Research Centre [ IS-BRC-1215-20018 ], Health and Social Care Research and Development (HSC R&D) Division , Public Health Agency [ COM/5516/18 ], Medical Research Council (MRC) Mental Health Data Pathfinder Award ( MC_PC_17,217 ), and the National Centre for Mental Health funding through Health and Care Research Wales . Profs Eley and Breen are part-funded by a program grant from the UK Medical Research Council ( MR/V012878/1 ). Dr Buckman was supported by a Clinical Research Fellowship from the Wellcome Trust (201292/Z/16/Z). Dr. Goldsmith receives funding from the National Institute for Health Research (NIHR), Medical Research Council (MRC), National Institutes of Health (NIH), and the Juvenile Diabetes Research Foundation (JDRF). Dr Krebs is funded by a Clinical Research Training Fellowship from the Medical Research Council ( MR/N001400/1 ). Dr H{\"u}bel acknowledges funding from Lundbeckfonden ( R276-2018-4581 ). Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2022",

month = jan,

doi = "10.1016/j.janxdis.2021.102491",

language = "English",

volume = "85",

journal = "Journal of Anxiety Disorders",

issn = "0887-6185",

publisher = "Elsevier Limited",

}

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 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, vol. 85, 102491. https://doi.org/10.1016/j.janxdis.2021.102491

TY - JOUR

T1 - Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts

AU - Davies, Molly R

AU - Buckman, Joshua E J

AU - Adey, Brett N

AU - Armour, Chérie

AU - Bradley, John R

AU - Curzons, Susannah C B

AU - Davies, Helena L

AU - Davis, Katrina A S

AU - Goldsmith, Kimberley A

AU - Hirsch, Colette R

AU - Hotopf, Matthew

AU - Hübel, Christopher

AU - Jones, Ian R

AU - Kalsi, Gursharan

AU - Krebs, Georgina

AU - Lin, Yuhao

AU - Marsh, Ian

AU - McAtarsney-Kovacs, Monika

AU - McIntosh, Andrew M

AU - Mundy, Jessica

AU - Monssen, Dina

AU - Peel, Alicia J

AU - Rogers, Henry C

AU - Skelton, Megan

AU - Smith, Daniel J

AU - Ter Kuile, Abigail

AU - Thompson, Katherine N

AU - Veale, David

AU - Walters, James T R

AU - Zahn, Roland

AU - Breen, Gerome

AU - Eley, Thalia C

N1 - Funding Information: We thank the GLAD Study and NIHR BioResource volunteers for their participation, and gratefully acknowledge the NIHR BioResource centres, NHS Trusts and staff for their contribution. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. This study presents independent research funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Further information can be found at http://brc.slam.nhs.uk/about/core-facilities/bioresource . The views expressed are those of the authors and not necessarily those of the NHS, NIHR, HSC R&D Division, Department of Health and Social Care. Funding Information: This work was supported by the National Institute for Health Research (NIHR) BioResource [RG94028, RG85445], National Institute for Health Research (NIHR) Biomedical Research Centre [IS-BRC-1215-20018], Health and Social Care Research and Development (HSC R&D) Division, Public Health Agency [COM/5516/18], Medical Research Council (MRC) Mental Health Data Pathfinder Award (MC_PC_17,217), and the National Centre for Mental Health funding through Health and Care Research Wales. Profs Eley and Breen are part-funded by a program grant from the UK Medical Research Council (MR/V012878/1). Dr Buckman was supported by a Clinical Research Fellowship from the Wellcome Trust (201292/Z/16/Z). Dr. Goldsmith receives funding from the National Institute for Health Research (NIHR), Medical Research Council (MRC), National Institutes of Health (NIH), and the Juvenile Diabetes Research Foundation (JDRF). Dr Krebs is funded by a Clinical Research Training Fellowship from the Medical Research Council (MR/N001400/1). Dr H?bel acknowledges funding from Lundbeckfonden (R276-2018-4581). Funding Information: This work was supported by the National Institute for Health Research ( NIHR ) BioResource [ RG94028 , RG85445 ], National Institute for Health Research (NIHR) Biomedical Research Centre [ IS-BRC-1215-20018 ], Health and Social Care Research and Development (HSC R&D) Division , Public Health Agency [ COM/5516/18 ], Medical Research Council (MRC) Mental Health Data Pathfinder Award ( MC_PC_17,217 ), and the National Centre for Mental Health funding through Health and Care Research Wales . Profs Eley and Breen are part-funded by a program grant from the UK Medical Research Council ( MR/V012878/1 ). Dr Buckman was supported by a Clinical Research Fellowship from the Wellcome Trust (201292/Z/16/Z). Dr. Goldsmith receives funding from the National Institute for Health Research (NIHR), Medical Research Council (MRC), National Institutes of Health (NIH), and the Juvenile Diabetes Research Foundation (JDRF). Dr Krebs is funded by a Clinical Research Training Fellowship from the Medical Research Council ( MR/N001400/1 ). Dr Hübel acknowledges funding from Lundbeckfonden ( R276-2018-4581 ). Publisher Copyright: © 2021 The Authors

PY - 2022/1

Y1 - 2022/1

N2 - 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.

AB - 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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U2 - 10.1016/j.janxdis.2021.102491

DO - 10.1016/j.janxdis.2021.102491

M3 - Article

C2 - 34775166

SN - 0887-6185

VL - 85

JO - Journal of Anxiety Disorders

JF - Journal of Anxiety Disorders

M1 - 102491

ER -

Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts

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