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

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number102491
JournalJournal of Anxiety Disorders
Volume85
Early online date26 Oct 2021
DOIs
Accepted/In press20 Oct 2021
E-pub ahead of print26 Oct 2021
PublishedJan 2022

Bibliographical 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 Hübel acknowledges funding from Lundbeckfonden ( R276-2018-4581 ). Funding Information: Prof Breen has received honoraria, research or conference grants and consulting fees from Illumina, Otsuka, and COMPASS Pathfinder Ltd. Prof Hotopf is principal investigator of the RADAR-CNS consortium, an IMI public private partnership, and as such receives research funding from Janssen, UCB, Biogen, Lundbeck and MSD. Prof McIntosh has received research support from Eli Lilly, Janssen, and the Sackler Foundation, and has also received speaker fees from Illumina and Janssen. Prof Walters has received grant funding from Takeda for work unrelated to the GLAD Study. Dr Zahn is a private psychiatrist service provider and co-investigator on a Livanova-funded observational study. He has received honoraria for talks at medical symposia sponsored by Lundbeck as well as Janssen. He collaborates with EMOTRA, EMIS PLC and Alloc Modulo. The remaining authors have nothing to disclose. Publisher Copyright: © 2021 The Authors

King's Authors

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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