TY  - JOUR
AB  - OBJECTIVES:Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores ?10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 ?10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. STUDY DESIGN AND SETTING:Individual participant data meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. RESULTS:A total of 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included. Pooled PHQ-9 ?10 prevalence was 24.6% (95% confidence interval [CI]: 20.8%, 28.9%); pooled SCID major depression prevalence was 12.1% (95% CI: 9.6%, 15.2%); and pooled difference was 11.9% (95% CI: 9.3%, 14.6%). The mean study-level PHQ-9 ?10 to SCID-based prevalence ratio was 2.5 times. PHQ-9 ?14 and the PHQ-9 diagnostic algorithm provided prevalence closest to SCID major depression prevalence, but study-level prevalence differed from SCID-based prevalence by an average absolute difference of 4.8% for PHQ-9 ?14 (95% prediction interval: -13.6%, 14.5%) and 5.6% for the PHQ-9 diagnostic algorithm (95% prediction interval: -16.4%, 15.0%). CONCLUSION:PHQ-9 ?10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies.
AU  - Levis, B
AU  - Benedetti, A
AU  - Ioannidis, JPA
AU  - Sun, Y
AU  - Negeri, Z
AU  - He, C
AU  - Wu, Y
AU  - Krishnan, A
AU  - Bhandari, PM
AU  - Neupane, D
AU  - Imran, M
AU  - Rice, DB
AU  - Riehm, KE
AU  - Saadat, N
AU  - Azar, M
AU  - Boruff, J
AU  - Cuijpers, P
AU  - Gilbody, S
AU  - Kloda, LA
AU  - McMillan, D
AU  - Patten, SB
AU  - Shrier, I
AU  - Ziegelstein, RC
AU  - Alamri, SH
AU  - Amtmann, D
AU  - Ayalon, L
AU  - Baradaran, HR
AU  - Beraldi, A
AU  - Bernstein, CN
AU  - Bhana, A
AU  - Bombardier, CH
AU  - Carter, G
AU  - Chagas, MH
AU  - Chibanda, D
AU  - Clover, K
AU  - Conwell, Y
AU  - Diez-Quevedo, C
AU  - Fann, JR
AU  - Fischer, FH
AU  - Gholizadeh, L
AU  - Gibson, LJ
AU  - Green, EP
AU  - Greeno, CG
AU  - Hall, BJ
AU  - Haroz, EE
AU  - Ismail, K
AU  - Jetté, N
AU  - Khamseh, ME
AU  - Kwan, Y
AU  - Lara, MA
AU  - Liu, S-I
AU  - Loureiro, SR
AU  - Löwe, B
AU  - Marrie, RA
AU  - Marsh, L
AU  - McGuire, A
AU  - Muramatsu, K
AU  - Navarrete, L
AU  - Osório, FL
AU  - Petersen, I
AU  - Picardi, A
AU  - Pugh, SL
AU  - Quinn, TJ
AU  - Rooney, AG
AU  - Shinn, EH
AU  - Sidebottom, A
AU  - Spangenberg, L
AU  - Tan, PLL
AU  - Taylor-Rowan, M
AU  - Turner, A
AU  - van Weert, HC
AU  - Vöhringer, PA
AU  - Wagner, LI
AU  - White, J
AU  - Winkley, K
AU  - Thombs, BD
DA  - 2020/06/01
DO  - 10.1016/j.jclinepi.2020.02.002
EP  - 128.e1
JO  - Journal of clinical epidemiology
PB  - ELSEVIER SCIENCE INC
PY  - 2020/06/01
SP  - 115
TI  - Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
VL  - 122
Y1  - 2020/06/01
Y2  - 2026/04/30
ER  -