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The validity of self-rated psychotic symptoms in depressed inpatients

Published online by Cambridge University Press:  15 April 2020

F. Seemüller ,
M. Riedel ,
M. Obermeier ,
R. Schennach-Wolff ,
I. Spellmann ,
S. Meyer ,
M. Bauer ,
M. Adli ,
K. Kronmüller  and
M. Ising
...Show all authors
F. Seemüller*
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
M. Riedel
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
M. Obermeier
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
R. Schennach-Wolff
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
I. Spellmann
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
S. Meyer
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
M. Bauer
Affiliation:
Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Dresden, Technical University Dresden, Fetscherstr. 74, 01307Dresden, Germany
M. Adli
Affiliation:
Department of Psychiatry and Psychotherapy, Campus, Charité Mitte (CCM), Charitéplatz 1, 10117Berlin, Germany
K. Kronmüller
Affiliation:
Department of Psychiatry and Psychotherapy, University of Heidelberg, Voßstr. 2, 69115Heidelberg, Germany
M. Ising
Affiliation:
Department of Psychiatry and Psychotherapy, Max Planck Institute of Psychiatry, Kraepelinstr. 2-7, 80804Munich, Germany
P. Brieger
Affiliation:
Department of Psychiatry and Psychotherapy, Martin-Luther University Halle-Wittenberg, Julius-Kühn-Str. 7, 06097Halle, Germany
G. Laux
Affiliation:
Department of Psychiatry and Psychotherapy, Inn-Salzach-Klinikum. Garbersee 7, 83512Wasserburg, Germany
W. Bender
Affiliation:
Department of Psychiatry and Psychotherapy, Isar-Amper-Klinikum Munich East, Vockestr. 72, 85540Haar, Germany
I. Heuser
Affiliation:
Department of Psychiatry and Psychotherapy, Campus Charité Benjamin Franklin (CFB), Eschenallee 3, 14050Berlin, Germany
J. Zeiler
Affiliation:
Department of Psychiatry and Psychotherapy, Auguste-Viktoria-Krankenhaus, Rubensstr. 125, 12157Berlin, Germany
W. Gaebel
Affiliation:
Department of Psychiatry and Psychotherapy, University of Düsseldorf, Bergische Landstr. 2, 40629Düsseldorf, Germany
H.-J. Möller
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336Munich, Germany
*
*Corresponding author. Tel.: +49 89 5160 5846; fax: +49 89 5160 5774. E-mail address:[email protected] (F. Seemüller).
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Abstract

Background

Self-ratings of psychotic experiences might be biased by depressive symptoms.

Method

Data from a large naturalistic multicentre trial on depressed inpatients (n = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.

Results

At discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P = 0.02).

Conclusions

In depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.

Keywords

Psychotic symptomsSCL-90Self-ratingDepression
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 7 , October 2012 , pp. 547 - 552
Copyright
Copyright © European Psychiatric Association 2012

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References

American Psychiatric Association Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry. 2000; 157: 1–45.Google Scholar
Bailey, J.Coppen, A.A comparison between the Hamilton Rating Scale and the Beck Inventory in the measurement of depression. Br J Psychiatry. 1976; 128: 486–489.CrossRefGoogle ScholarPubMed
Bauer, M.Bschor, T.Pfennig, A.Whybrow, P.C.Angst, J.Versiani, M.et al.World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for biological treatment of unipolar depressive disorders in primary care. World J Biol Psychiatry. 2007; 8(2): 67–104.CrossRefGoogle ScholarPubMed
Beck, T.Ward, H.Mendelsson, M.Mok, J.Erbaugh, J.An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4: 561–571.CrossRefGoogle ScholarPubMed
Bijl, R.V.Ravelli, A.van Zessen, G.Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol. 1998; 33(12): 587–595.CrossRefGoogle ScholarPubMed
David, A.S.Why we need more debate on whether psychotic symptoms lie on a continuum with normality. Psychol Med. 2010 1–8 [vol. First View].Google ScholarPubMed
Demyttenaere, K.Desaiah, D.Petit, C.Croenlein, J.Brecht, S.Patient-assessed versus physician-assessed disease severity and outcome in patients with nonspecific pain associated with major depressive disorder. Primary Care Companion J Clin Psychiatry. 2009; 11(1): 8–15.CrossRefGoogle ScholarPubMed
Egli, S.Riedel, M.Möller, H.J.Strauss, A.Lage, D.Creating a map of psychiatric patients based on psychopathological symptom profiles. Eur Arch Psychiatry Clin Neurosci. 2009; 259(3): 164–171.CrossRefGoogle ScholarPubMed
Guy, W.Clinical Global Impressions, ECDEU Assessment Manual for Psychopharmacology. National Institute of Mental Health. Rockville: MD revised; 1976.Google Scholar
Hamilton, M.Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967; 6(4): 278–296.CrossRefGoogle ScholarPubMed
Johns, L.C.van Os, J.The continuity of psychotic experiences in the general population. Clin Psychol Rev. 2001; 21(8): 1125–1141.CrossRefGoogle ScholarPubMed
Kendler, K.S.Gallagher, T.J.Abelson, J.M.Kessler, R.C.Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Arch Gen Psychiatry. 1996; 53(11): 1022–1031.CrossRefGoogle Scholar
McGlashan, T.H.Zipursky, R.B.Perkins, D.Addington, J.Miller, T.Woods, S.W.et al.Randomized, double-blind trial of olanzapine versus placebo in patients prodromally symptomatic for psychosis. Am J Psychiatry. 2006; 163(5): 790–799.CrossRefGoogle Scholar
McGorry, P.D.Yung, A.R.Phillips, L.J.Yuen, H.P.Francey, S.Cosgrave, E.M.et al.Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Arch Gen Psychiatry. 2002; 59(10): 921–928.CrossRefGoogle Scholar
Möller, H.J.Outcome criteria in antidepressant drug trials: self-rating versus observer-rating scales. Pharmacopsychiatry. 1991; 24(3): 71–75.CrossRefGoogle ScholarPubMed
Möller, H.J.Rating depressed patients: observer- vs self-assessment. Eur Psychiatry. 2000; 15(3): 160–172.CrossRefGoogle ScholarPubMed
Montgomery, S.A.Asberg, M.A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979; 134: 382–389.CrossRefGoogle ScholarPubMed
Ochoa, S.Haro, J.M.Torres, J.V.Pinto-Meza, A.Palacin, C.Bernal, M.et al.What is the relative importance of self reported psychotic symptoms in epidemiological studies? Results from the ESEMeD--Catalonia Study. Schizophrenia Res. 102 1–3: 2008 261–269.CrossRefGoogle ScholarPubMed
Ohayon, M.M.Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Res. 97 2–3: 2000 153–164.CrossRefGoogle ScholarPubMed
Pietzcker, A.Gebhardt, R.Depressive syndromes and scales in the AMDP-system. Acta Psychiatrica Scandinavica Suppl. 1983; 310(8): 65–84.CrossRefGoogle ScholarPubMed
Pietzcker, A.Gebhardt, R.Strauss, A.Stockel, M.Langer, C.Freudenthal, K.The syndrome scales in the AMDP-System. Mod Prob Pharmacopsychiatry. 1983; 20: 88–99.CrossRefGoogle ScholarPubMed
Rauter, U.K.Leonard, C.E.Swett, C.P.SCL-90-R factor structure in an acute, involuntary, adult psychiatric inpatient sample. J Clin Psychol. 1996; 52(6): 625–629.3.0.CO;2-J>CrossRefGoogle Scholar
Rossler, W.Riecher-Rossler, A.Angst, J.Murray, R.Gamma, A.Eich, D.et al.Psychotic experiences in the general population: a twenty-year prospective community study. Schizophrenia Res. 2007; 92: 1–14.CrossRefGoogle ScholarPubMed
Schmitz, N.Hartkamp, N.Kiuse, J.Franke, G.H.Reister, G.Tress, W.The Symptom Check-List-90-R (SCL-90-R): a German validation study. Qual Life Res. 2000; 9(2): 185–193.CrossRefGoogle ScholarPubMed
Seemuller, F.Riedel, M.Obermeier, M.Bauer, M.Adli, M.Kronmuller, K.et al.Outcomes of 1014 naturalistically treated inpatients with major depressive episode. Eur Neuropsychopharmacol. 2010; 20(5): 346–355.CrossRefGoogle ScholarPubMed
van der Werf, M.van Boxtel, M.Verhey, F.Jolles, J.Thewissen, V.van Os, J.Mild hearing impairment and psychotic experiences in a normal aging population. Schizophrenia Res. 94 1–3: 2007 180–186.CrossRefGoogle Scholar
van Os, J.Hanssen, M.Bijl, R.V.Ravelli, A.Strauss (1969) revisited: a psychosis continuum in the general population?. Schizophrenia Res. 45 1–2: 2000 11–20.CrossRefGoogle ScholarPubMed
van Os, J.Hanssen, M.Bijl, R.V.Vollebergh, W.Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. Arch General Psychiatry. 2001; 58(7): 663–668.CrossRefGoogle Scholar
von Zerssen, D.Self-rating scales for evaluation of patient's subjective state in cross-sectional and longitudinal studies of psychopathology. Archiv für Psychiatrie und Nervenkrankheiten. 1973; 17(3): 299–314.Google Scholar
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