Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence
Standard
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence : individual participant data meta-analysis. / Levis, Brooke; Benedetti, Andrea; Ioannidis, John P A; Sun, Ying; Negeri, Zelalem; He, Chen; Wu, Yin; Krishnan, Ankur; Bhandari, Parash Mani; Neupane, Dipika; Imran, Mahrukh; Rice, Danielle B; Riehm, Kira E; Saadat, Nazanin; Azar, Marleine; Boruff, Jill; Cuijpers, Pim; Gilbody, Simon; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Shrier, Ian; Ziegelstein, Roy C; Alamri, Sultan H; Amtmann, Dagmar; Ayalon, Liat; Baradaran, Hamid R; Beraldi, Anna; Bernstein, Charles N; Bhana, Arvin; Bombardier, Charles H; Carter, Gregory; Chagas, Marcos H; Chibanda, Dixon; Clover, Kerrie; Conwell, Yeates; Diez-Quevedo, Crisanto; Fann, Jesse R; Fischer, Felix H; Gholizadeh, Leila; Gibson, Lorna J; Green, Eric P; Greeno, Catherine G; Hall, Brian J; Haroz, Emily E; Ismail, Khalida; Jetté, Nathalie; Khamseh, Mohammad E; Kwan, Yunxin; Lara, Maria Asunción; Liu, Shen-Ing; Loureiro, Sonia R; Löwe, Bernd; Marrie, Ruth Ann; Marsh, Laura; McGuire, Anthony; Muramatsu, Kumiko; Navarrete, Laura; Osório, Flávia L; Petersen, Inge; Picardi, Angelo; Pugh, Stephanie L; Quinn, Terence J; Rooney, Alasdair G; Shinn, Eileen H; Sidebottom, Abbey; Spangenberg, Lena; Lynnette Tan, Pei Lin; Taylor-Rowan, Martin; Turner, Alyna; van Weert, Henk C; Vöhringer, Paul A; Wagner, Lynne I; White, Jennifer; Winkley, Kirsty; Thombs, Brett D.
In: J CLIN EPIDEMIOL, Vol. 122, 06.2020, p. 115-128.e1.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence
T2 - individual participant data meta-analysis
AU - Levis, Brooke
AU - Benedetti, Andrea
AU - Ioannidis, John P A
AU - Sun, Ying
AU - Negeri, Zelalem
AU - He, Chen
AU - Wu, Yin
AU - Krishnan, Ankur
AU - Bhandari, Parash Mani
AU - Neupane, Dipika
AU - Imran, Mahrukh
AU - Rice, Danielle B
AU - Riehm, Kira E
AU - Saadat, Nazanin
AU - Azar, Marleine
AU - Boruff, Jill
AU - Cuijpers, Pim
AU - Gilbody, Simon
AU - Kloda, Lorie A
AU - McMillan, Dean
AU - Patten, Scott B
AU - Shrier, Ian
AU - Ziegelstein, Roy C
AU - Alamri, Sultan H
AU - Amtmann, Dagmar
AU - Ayalon, Liat
AU - Baradaran, Hamid R
AU - Beraldi, Anna
AU - Bernstein, Charles N
AU - Bhana, Arvin
AU - Bombardier, Charles H
AU - Carter, Gregory
AU - Chagas, Marcos H
AU - Chibanda, Dixon
AU - Clover, Kerrie
AU - Conwell, Yeates
AU - Diez-Quevedo, Crisanto
AU - Fann, Jesse R
AU - Fischer, Felix H
AU - Gholizadeh, Leila
AU - Gibson, Lorna J
AU - Green, Eric P
AU - Greeno, Catherine G
AU - Hall, Brian J
AU - Haroz, Emily E
AU - Ismail, Khalida
AU - Jetté, Nathalie
AU - Khamseh, Mohammad E
AU - Kwan, Yunxin
AU - Lara, Maria Asunción
AU - Liu, Shen-Ing
AU - Loureiro, Sonia R
AU - Löwe, Bernd
AU - Marrie, Ruth Ann
AU - Marsh, Laura
AU - McGuire, Anthony
AU - Muramatsu, Kumiko
AU - Navarrete, Laura
AU - Osório, Flávia L
AU - Petersen, Inge
AU - Picardi, Angelo
AU - Pugh, Stephanie L
AU - Quinn, Terence J
AU - Rooney, Alasdair G
AU - Shinn, Eileen H
AU - Sidebottom, Abbey
AU - Spangenberg, Lena
AU - Lynnette Tan, Pei Lin
AU - Taylor-Rowan, Martin
AU - Turner, Alyna
AU - van Weert, Henk C
AU - Vöhringer, Paul A
AU - Wagner, Lynne I
AU - White, Jennifer
AU - Winkley, Kirsty
AU - Thombs, Brett D
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - 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.
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.
U2 - 10.1016/j.jclinepi.2020.02.002
DO - 10.1016/j.jclinepi.2020.02.002
M3 - SCORING: Journal article
C2 - 32105798
VL - 122
SP - 115-128.e1
JO - J CLIN EPIDEMIOL
JF - J CLIN EPIDEMIOL
SN - 0895-4356
ER -