I am doing a study in which we get a Montgomery-Asberg Depression Rating Scale (MADRS) at three time points (baseline, 2 weeks, and 4 weeks). I have a subject who reported at the 2-week time point that he'd previously been minimizing some of his symptoms at the baseline time point. Most notably, he said that he didn't tell us about his suicidal thoughts because he was worried that we'd hospitalize him. He now reports more suicidal thoughts than what he told us at baseline, but also says that he's only admitting it to us now because it's improved to the point that he's no longer concerned about being hospitalized. If we follow the most stringent definition of the scale, he received a "2" for that question at baseline and now he gets a "4" for that question. However, I feel that this misrepresents the patient's actual symptoms. Is there a reasonable/ethical way to address this or do I just have to accept this as one of the limitations of my methodology?