CAN SELF‐RATING REPLACE DOCTOR'S RATING IN EVALUATING ANTI‐DEPRESSIVE TREATMENT?

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Abstract
Sixteen depressive out‐patients with endogenous or mixed endogenous‐psychogenic depression were rated before and during antidepressive drug treatment using the Zung self‐rating scale, the Cronholm‐Ottosson depression scale and a global rating. The scores displayed a parallel course, but the correlations between them were only moderate, and between the score differences were still lower. When levels of significance of score differences and global ratings were used as measures of treatment effects, the self‐ratings were least sensitive. The study gives no support for a replacement of the doctor's rating scale with self‐rating according to Zung.Even when the correlations are higher, they should not without reservation be taken as evidence of validity of the self‐rating, since they may be spuriously inflated. Estimation of reliability of selfrating presents difficulties, and psychotic symptoms cannot be properly evaluated. Seeing depressive illness as a hypothetical construct, self‐rating may be used as an additional indicator, but it cannot replace doctor's ratings.