Self-assessment of DSM-IV criteria for major depression in psychiatric out- and inpatients

The Depression Self-Rating Scale (DSRS) is a self-report inventory based on the DSM-IV criteria for major depression. This study aimed to investigate diagnostic concordance of a major depressive disorder (MDD) using the DSRS and the Structured Clinical Interview for DSM-IV, axis I disorders (SCID-I). An additional aim was to investigate whether concordance could be improved by adding different cut-off scores for the Beck Depression Inventory (BDI) or the self-report version of the Montgomery-Asberg Depression Rating Scale (MADRS-S). MDD was determined by means of the SCID-I interview and the DSRS in 83 psychiatric in- and outpatients. Depressive severity was assessed using the BDI and the MADRS-S. A DSRS-version including the A- and C-criteria for an MDD had a sensitivity and a specificity for an expert-rated diagnosis of 86% and 75%, respectively. By using cut-off scores for the BDI or the MADRS-S, specificity could be raised to 85% without loss of sensitivity. The DSRS appears to be a useful instrument in the diagnostic process involving MDD, particularly when used in combination with the BDI or the MADRS-S. The DSRS is thought to be of value in psychiatric outpatient departments, where treatment of patients is often delegated to paramedical staff or nurses. The scale might also be used as an independent diagnostic tool in epidemiological studies in order to achieve an estimate of the prevalence of MDD in different population settings.