Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9

TY - JOUR

T1 - Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9

T2 - a systematic review and individual participant data meta-analysis

AU - Wu, Yin

AU - Levis, Brooke

AU - Riehm, Kira E

AU - Saadat, Nazanin

AU - Levis, Alexander W

AU - Azar, Marleine

AU - Rice, Danielle B

AU - Boruff, Jill

AU - Cuijpers, Pim

AU - Gilbody, Simon

AU - Ioannidis, John P A

AU - Kloda, Lorie A

AU - McMillan, Dean

AU - Patten, Scott B

AU - Shrier, Ian

AU - Ziegelstein, Roy C

AU - Akena, Dickens H

AU - Arroll, Bruce

AU - Ayalon, Liat

AU - Baradaran, Hamid R

AU - Baron, Murray

AU - Bombardier, Charles H

AU - Butterworth, Peter

AU - Carter, Gregory

AU - Chagas, Marcos H

AU - Chan, Juliana C N

AU - Cholera, Rushina

AU - Conwell, Yeates

AU - de Man-van Ginkel, Janneke M

AU - Fann, Jesse R

AU - Fischer, Felix H

AU - Fung, Daniel

AU - Gelaye, Bizu

AU - Goodyear-Smith, Felicity

AU - Greeno, Catherine G

AU - Hall, Brian J

AU - Harrison, Patricia A

AU - Härter, Martin

AU - Hegerl, Ulrich

AU - Hides, Leanne

AU - Hobfoll, Stevan E

AU - Hudson, Marie

AU - Hyphantis, Thomas

AU - Inagaki, M D

AU - Jetté, Nathalie

AU - Khamseh, Mohammad E

AU - Kiely, Kim M

AU - Kwan, Yunxin

AU - Lamers, Femke

AU - Liu, Shen-Ing

AU - Lotrakul, Manote

AU - Loureiro, Sonia R

AU - Löwe, Bernd

AU - McGuire, Anthony

AU - Mohd-Sidik, Sherina

AU - Munhoz, Tiago N

AU - Muramatsu, Kumiko

AU - Osório, Flávia L

AU - Patel, Vikram

AU - Pence, Brian W

AU - Persoons, Philippe

AU - Picardi, Angelo

AU - Reuter, Katrin

AU - Rooney, Alasdair G

AU - Santos, Iná S

AU - Shaaban, Juwita

AU - Sidebottom, Abbey

AU - Simning, Adam

AU - Stafford, M D

AU - Sung, Sharon

AU - Tan, Pei Lin Lynnette

AU - Turner, Alyna

AU - van Weert, Henk C

AU - White, Jennifer

AU - Whooley, Mary A

AU - Winkley, Kirsty

AU - Yamada, Mitsuhiko

AU - Benedetti, Andrea

AU - Thombs, Brett D

PY - 2020/6

Y1 - 2020/6

N2 - BACKGROUND: Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.METHODS: We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.RESULTS: 16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).CONCLUSIONS: PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.

AB - BACKGROUND: Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.METHODS: We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.RESULTS: 16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).CONCLUSIONS: PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.

U2 - 10.1017/S0033291719001314

DO - 10.1017/S0033291719001314

M3 - SCORING: Journal article

C2 - 31298180

VL - 50

SP - 1368

EP - 1380

JO - PSYCHOL MED

JF - PSYCHOL MED

SN - 0033-2917

IS - 8

ER -