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This study explored whether a similar effect occurs in adolescents and whether initial agreement vs. disagreement between self- and clinician ratings predicts differential outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      The analyzed data stem from a randomized controlled trial (DeLight) that explored the effect of bright light therapy as an add-on to treatment as usual in an inpatient sample of adolescents (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009224). Depression was assessed at four time points (baseline, 4 weeks, 16 weeks, 28 weeks) using the Beck Depression Inventory (BDI-II) as a self-report measure and the Children\u2019s Depression Rating Scale - Revised (CDRS-R) as a blinded clinician rating.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The correlation between self- and clinician ratings was only moderate at baseline (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.40) but increased considerably to a strong correlation at four weeks (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.72), which was maintained thereafter. The predictive value of initial rater agreement \/ disagreement for the outcome was small (BDI-II) or non-significant (CDRS-R). Further analyses revealed that the reliability of both instruments increased over time and the factor structure became simpler, with fewer factors and higher factor loadings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings indicate increasing homogeneity within self- and clinician ratings over time and suggest that some type of response shift occurred, with adolescents appearing to increasingly view their depression as a unified concept. A consideration of response shifts could lead to more accurate assessments of treatment effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13034-025-00993-3","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T10:05:52Z","timestamp":1763201152000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Concordance between self- and clinician ratings of depression during inpatient treatment in adolescents: changes over time and probable response shift"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6890-3869","authenticated-orcid":false,"given":"Ferdinand","family":"Keller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Holtmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"K\u00f6lch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Legenbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"993_CR1","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.jad.2015.10.054","volume":"190","author":"Z Bukumiric","year":"2016","unstructured":"Bukumiric Z, Starcevic V, Stanisavljevic D, et al. 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