Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
Levis, B
Benedetti, A
Ioannidis, JPA
Sun, Y
Negeri, Z
He, C
Wu, Y
Krishnan, A
Bhandari, PM
Neupane, D
Imran, M
Rice, DB
Riehm, KE
Saadat, N
Azar, M
Boruff, J
Cuijpers, P
Gilbody, S
Kloda, LA
McMillan, D
Patten, SB
Shrier, I
Ziegelstein, RC
Alamri, SH
Amtmann, D
Ayalon, L
Baradaran, HR
Beraldi, A
Bernstein, CN
Bhana, A
Bombardier, CH
Carter, G
Chagas, MH
Chibanda, D
Clover, K
Conwell, Y
Diez-Quevedo, C
Fann, JR
Fischer, FH
Gholizadeh, L
Gibson, LJ
Green, EP
Greeno, CG
Hall, BJ
Haroz, EE
Ismail, K
Jetté, N
Khamseh, ME
Kwan, Y
Lara, MA
Liu, S-I
Loureiro, SR
Löwe, B
Marrie, RA
Marsh, L
McGuire, A
Muramatsu, K
Navarrete, L
Osório, FL
Petersen, I
Picardi, A
Pugh, SL
Quinn, TJ
Rooney, AG
Shinn, EH
Sidebottom, A
Spangenberg, L
Tan, PLL
Taylor-Rowan, M
Turner, A
van Weert, HC
Vöhringer, PA
Wagner, LI
White, J
Winkley, K
Thombs, BD
- Publisher:
- ELSEVIER SCIENCE INC
- Publication Type:
- Journal Article
- Citation:
- Journal of clinical epidemiology, 2020, 122, pp. 115-128.e1
- Issue Date:
- 2020-06
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Levis, B | |
dc.contributor.author | Benedetti, A | |
dc.contributor.author | Ioannidis, JPA | |
dc.contributor.author | Sun, Y | |
dc.contributor.author | Negeri, Z | |
dc.contributor.author | He, C | |
dc.contributor.author | Wu, Y | |
dc.contributor.author | Krishnan, A | |
dc.contributor.author | Bhandari, PM | |
dc.contributor.author | Neupane, D | |
dc.contributor.author | Imran, M | |
dc.contributor.author | Rice, DB | |
dc.contributor.author | Riehm, KE | |
dc.contributor.author | Saadat, N | |
dc.contributor.author | Azar, M | |
dc.contributor.author | Boruff, J | |
dc.contributor.author | Cuijpers, P | |
dc.contributor.author | Gilbody, S | |
dc.contributor.author | Kloda, LA | |
dc.contributor.author | McMillan, D | |
dc.contributor.author | Patten, SB | |
dc.contributor.author | Shrier, I | |
dc.contributor.author | Ziegelstein, RC | |
dc.contributor.author | Alamri, SH | |
dc.contributor.author | Amtmann, D | |
dc.contributor.author | Ayalon, L | |
dc.contributor.author | Baradaran, HR | |
dc.contributor.author | Beraldi, A | |
dc.contributor.author | Bernstein, CN | |
dc.contributor.author | Bhana, A | |
dc.contributor.author | Bombardier, CH | |
dc.contributor.author | Carter, G | |
dc.contributor.author | Chagas, MH | |
dc.contributor.author | Chibanda, D | |
dc.contributor.author | Clover, K | |
dc.contributor.author | Conwell, Y | |
dc.contributor.author | Diez-Quevedo, C | |
dc.contributor.author | Fann, JR | |
dc.contributor.author | Fischer, FH | |
dc.contributor.author |
Gholizadeh, L https://orcid.org/0000-0002-6711-3312 |
|
dc.contributor.author | Gibson, LJ | |
dc.contributor.author | Green, EP | |
dc.contributor.author | Greeno, CG | |
dc.contributor.author | Hall, BJ | |
dc.contributor.author | Haroz, EE | |
dc.contributor.author | Ismail, K | |
dc.contributor.author | Jetté, N | |
dc.contributor.author | Khamseh, ME | |
dc.contributor.author | Kwan, Y | |
dc.contributor.author | Lara, MA | |
dc.contributor.author | Liu, S-I | |
dc.contributor.author | Loureiro, SR | |
dc.contributor.author | Löwe, B | |
dc.contributor.author | Marrie, RA | |
dc.contributor.author | Marsh, L | |
dc.contributor.author | McGuire, A | |
dc.contributor.author | Muramatsu, K | |
dc.contributor.author | Navarrete, L | |
dc.contributor.author | Osório, FL | |
dc.contributor.author | Petersen, I | |
dc.contributor.author | Picardi, A | |
dc.contributor.author | Pugh, SL | |
dc.contributor.author | Quinn, TJ | |
dc.contributor.author | Rooney, AG | |
dc.contributor.author | Shinn, EH | |
dc.contributor.author | Sidebottom, A | |
dc.contributor.author | Spangenberg, L | |
dc.contributor.author | Tan, PLL | |
dc.contributor.author | Taylor-Rowan, M | |
dc.contributor.author | Turner, A | |
dc.contributor.author | van Weert, HC | |
dc.contributor.author | Vöhringer, PA | |
dc.contributor.author | Wagner, LI | |
dc.contributor.author | White, J | |
dc.contributor.author | Winkley, K | |
dc.contributor.author | Thombs, BD | |
dc.date.accessioned | 2020-08-31T05:51:31Z | |
dc.date.available | 2021-08-12T19:00:52Z | |
dc.date.issued | 2020-06 | |
dc.identifier.citation | Journal of clinical epidemiology, 2020, 122, pp. 115-128.e1 | |
dc.identifier.issn | 0895-4356 | |
dc.identifier.issn | 1878-5921 | |
dc.identifier.uri | http://hdl.handle.net/10453/142444 | |
dc.description.abstract | 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. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | ELSEVIER SCIENCE INC | |
dc.relation.ispartof | Journal of clinical epidemiology | |
dc.relation.isbasedon | 10.1016/j.jclinepi.2020.02.002 | |
dc.rights | info:eu-repo/semantics/embargoedAccess | |
dc.subject | 01 Mathematical Sciences, 11 Medical and Health Sciences | |
dc.subject.classification | Epidemiology | |
dc.title | Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis. | |
dc.type | Journal Article | |
utslib.citation.volume | 122 | |
utslib.location.activity | United States | |
utslib.for | 01 Mathematical Sciences | |
utslib.for | 11 Medical and Health Sciences | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | /University of Technology Sydney/Strength - CHSP - Health Services and Practice | |
pubs.organisational-group | /University of Technology Sydney | |
utslib.copyright.status | open_access | * |
pubs.consider-herdc | false | |
dc.date.updated | 2020-08-31T05:51:26Z | |
pubs.publication-status | Published | |
pubs.volume | 122 |
Abstract:
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.
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