Determinants of self‐rating and expert rating concordance in psychiatric out‐patients, using the affective subscales of the CPRS

Abstract

To investigate in more detail concordance between the recently developed Comprehensive Psychopathological Rating Scale (CPRS) and the recently developed Self-Rating Scale for Affective Syndromes (CPRS-S-A), a total of 101 psychiatric out-patients were assessed using these procedures and a diagnostic interview according to DSM-III-R. Depressive and anxiety syndromes were the most common diagnoses on Axis I. Approximately one-third of the patients had a diagnosis of clinical personality disorder on Axis II. The majority of the patients were assessed as predominantly manifesting either Cluster B or Cluster C traits. In general, the correlation between self- and expert-ratings was strong (0.83 for the Montgomery-Asberg Rating Scale (MADRS) depression subscale and 0.76 for the Brief Scale for Anxiety (BSA) anxiety subscale), but it tended to be weaker in the group of patients with clinical personality disorders. The correlation between the two ratings was also weaker in the group with predominantly Cluster B character traits than in the group with predominantly Cluster C traits or the group with no predominant traits, and weaker in the depressive group than in the anxiety group. However, personality disorder diagnoses were over-represented in the depressive group. The weaker correlations in the groups mentioned above may have been attributable to psychological factors and qualitative differences in cognitive and communicative style. The CPRS-S-A is considered to be a useful and reliable instrument for quantitative rating of symptoms in out-patients. Our results highlight the potential value of using appropriate self-assessment forms as complementary tools in clinical practice and research.