A time-varying measurement error model for age of onset of a psychiatric diagnosis: applied to first depressive episode diagnosed by the Composite International Diagnostic Interview (CIDI)

A substantial degree of uncertainty exists surrounding the reconstruction of events based on memory recall. This form of measurement error affects the performance of structured interviews such as the Composite International Diagnostic Interview (CIDI), an important tool to assess mental health in the community. Measurement error probably explains the discrepancy in estimates between longitudinal studies with repeated assessments (the gold-standard), yielding approximately constant rates of depression, versus cross-sectional studies which often find increasing rates closer in time to the interview. Repeated assessments of current status (or recent history) are more reliable than reconstruction of a person's psychiatric history based on a single interview. In this paper, we demonstrate a method of estimating a time-varying measurement error distribution in the age of onset of an initial depressive episode, as diagnosed by the CIDI, based on an assumption regarding age-specific incidence rates. High-dimensional non-parametric estimation is achieved by the EM-algorithm with smoothing. The method is applied to data from a Norwegian mental health survey in 2000. The measurement error distribution changes dramatically from 1980 to 2000, with increasing variance and greater bias further away in time from the interview. Some influence of the measurement error on already published results is found.