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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
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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:florian.seemueller@med.uni-muenchen.de (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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