THE RELATIONSHIP OF SELF-REPORTED DISTRESS TO DEPRESSIVE-DISORDERS AND OTHER PSYCHOPATHOLOGY

The relationship between self-reported depression and a clinical diagn osis of depression was investigated. Within 2 weeks of completing the Center for Epidemiologic Studies Depression Scale (CES-D), a stratifie d sample of 425 primary medical care patients received the structured interview for the DSM-III-R. In the weighted data set, the CES-D was s ignificantly related to a diagnosis of depression but also to other Ax is I disorders. Most distressed subjects were not depressed, a fifth o f the patients with major depressive disorder (MDD) had low distress, and the CES-D performed as well in detecting anxiety as in detecting d epression. MDD, other depression diagnoses, and anxiety and substance use disorders were all significant predictors of CES-D score. Differen ces in demographic variables, treatment history, and impairment highli ght the nonequivalence of the self-report scale and diagnosable depres sion. The use of a self-report in place of an interview-based diagnost ic measure in the study of depression, as well as the use of such a re port as a screening device, is discussed.