Am J Psychiatry 1995; 152:1608-1614
Copyright © 1995 by American Psychiatric Association
Validity of a diagnosis of lifetime major depression obtained by personal interview versus family history
KS Kendler and MA Roy
Department of Psychiatry, Medical College of Virginia, Richmond 23298- 0710, USA.
OBJECTIVE: Diagnoses obtained by family history agree only modestly with
those obtained through personal interview. If personal interview diagnoses
are the "gold standard," these findings suggest that family history
diagnoses have low validity. Here the authors take another perspective--to
evaluate family history versus personal interview diagnoses of lifetime
major depression by three independent validators. METHOD: In a large sample
of female-female twin pairs and their parents (903 families) ascertained
from a population-based twin register, all subjects were personally
interviewed by using a modified Structured Clinical Interview for
DMS-III-R. Family history diagnoses based on the Family History Research
Diagnostic Criteria were obtained by questioning each participant about his
or her relatives. By means of multiple regression, the powers of the
personal interview and family history methods were compared to predict 1)
future episodes of major depression in the twins, 2) neuroticism, and 3)
familial aggregation of major depression. RESULTS: Agreement between
diagnoses obtained by personal interview and family history was modest.
After the presence or absence of a personal interview diagnosis of major
depression was controlled for, a family history diagnosis of major
depression significantly predicted future episodes of major depression,
neuroticism (in five of six analyses), and familial aggregation of major
depression (in four of six analyses). CONCLUSIONS: Although agreeing
relatively poorly, diagnoses of lifetime major depression obtained by
personal interview and family history both contained useful information
about future episodes, personality, and familial liability to illness. A
multimethod approach to assessment of psychiatric illness may maximize the
validity of psychiatric diagnoses.
