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High agreement of self-report and physician-diagnosed somatic conditions yields limited bias in examining mental–physical comorbidity
Abstract
Objective To quantify the misclassification bias of self-reported somatic diseases and its impact on the estimation of comorbidity with mental disorders.Study design and setting Data were drawn from the German National Health Interview and Examination Survey (N=7,124), which assessed both self-reported and physician-diagnosed somatic diseases. Eight chronic diseases were examined: coronary heart disease, heart failure, asthma, chronic bronchitis, diabetes, cancer, arthrosis, and arthritis. Mental disorders were assessed by means of the Munich-Composite International Interview.Results The agreement of case ascertainment by patient self-report and physician diagnosis was high (kappa: 0.74-0.92), except for arthritis (0.53). False-positive and false-negative disease statuses were partly associated with age, sex, socioeconomic status, somatic comorbidities, marital status, and mood and anxiety disorders. In most conditions, the odds ratios (ORs) of comorbid mental disorders based on self-reported diseases were slightly overestimated with regard to mood disorders (relative OR: 0.91-1.38), whereas there proved to be no such trend regarding anxiety disorders (0.82-1.05). Substance disorders were partly biased without showing an interpretable trend across diseases (0.49-2.58).Conclusions Evaluation of mental-physical comorbidity based on self-reported and physician-diagnosed physical conditions yielded similar results, with modestly inflated ORs for mood disorders for several self-reported physical conditions.
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“On the other hand, a self-reported checklist of long-term diseases has been commonly used as a valid option in research [67].”
From Associations of childhood trauma with long-term diseases and alcohol and nicotine use disorders in Czech and Slovak representative samples (2022) · cites this paper as [67]
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Metadata
- Authors
- Baumeister, H., Kriston, L., Bengel, J., & Härter, M.
- Affiliations
- University of Freiburg (DE)
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Baumeister, Harald
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 63
- Issue
- 5
- Pages
- 558-565
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W2045088712
- Cited by
- 201
- References
- 32
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 13 · 2020: 11 · 2019: 9 · 2018: 19 · 2017: 10 · 2016: 12 · 2015: 14 · 2014: 21 · 2013: 15 · 2012: 13
- FWCI
- 6.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Technische Universität Dresden
- Robert Koch Institut
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- misclassification bias, mood disorders, anxiety disorders, chronic disease, arthritis, coronary artery disease, diabetes mellitus, cancer, arthrosis, asthma, chronic bronchitis
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Mental Disorders, Chronic Disease, Diagnostic Errors, Epidemiologic Methods, Female, Germany, Humans, Male, Middle Aged, Self Disclosure, Sex Factors, Socioeconomic Factors, Comorbidity, Bias, Young Adult
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