- Title
- Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis
- Creator
- Levis, Brooke; Benedetti, Andrea; Imran, Mahrukh; Rice, Danielle B.; Riehm, Kira E.; Saadat, Nazanin; Azar, Marleine; Boruff, Jill; Cuijpers, Pim; Gilbody, Simon; Kloda, Lorie A.; McMillan, Dean; Ioannidis, John P. A.; Patten, SB; Shrier, I; Ziegelstein, RC; Alamri, SH; Amtmann, D; Ayalon, L; Baradaran, HR; Beraldi, A; Bernstein, CN; Bhana, A; Sun, Ying; Bombardier, CH; Carter, Gregory; Chagas, MH; Chibanda, D; Clover, Kerrie; Conwell, Y; Diez-Quevedo, C; Fann, JR; Fischer, FH; Gholizadeh, L; Negeri, Zelalem; Gibson, LJ; Green, EP; Greeno, CG; Hall, BJ; Haroz, EE; Ismail, K; Jetté, N; Khamseh, ME; Kwan, Y; Lara, MA; He, Chen; Liu, SI; Loureiro, SR; Löwe, B; Marrie, RA; Marsh, L; McGuire, A; Muramatsu, K; Navarrete, L; Osório, FL; Petersen, I; Wu, Yin; Picardi, A; Pugh, SL; Quinn, TJ; Rooney, AG; Shinn, EH; Sidebottom, A; Spangenberg, L; Tan, PLL; Taylor-Rowan, M; Turner, Alyna; Krishnan, Ankur; van Weert, HC; Vöhringer, PA; Wagner, LI; White, J; Winkley, K; Thombs, BD; Bhandari, Parash Mani; Neupane, Dipika
- Relation
- Journal of Clinical Epidemiology Vol. 122, Issue June 2020, p. 115-128.E1
- Publisher Link
- http://dx.doi.org/10.1016/j.jclinepi.2020.02.002
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2020
- Description
- 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.
- Subject
- depression prevalence; PHQ-9; SCID; individual participant data meta-analysis
- Identifier
- http://hdl.handle.net/1959.13/1431403
- Identifier
- uon:38957
- Identifier
- ISSN:0895-4356
- Language
- eng
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