Self-ratings naturally emphasize the subjective and affective elements: the experience of depression. The practical advantages of the self-report are speed and economy because they do not require clinical observation. The disadvantages include the lack of specificity of self-report methods: they identify dysfunction but cannot distinguish depression from general malaise. Only a clinical rating can record nonverbal indicators of depression, and a clinical rating can handle distorting factors such as denial or exaggeration. Somatic symptoms are not accurately recorded by self-assessment, producing false positive results among medically ill and elderly persons (21, pp92,94), a difficulty that is easier to control in the clinical interview. This echoes the debate over the Health Opinion Survey described in Chapter 5.