Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis

Levis, B. et al. (2020) Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis. Journal of Clinical Epidemiology, 122, 115-128.e1. (doi: 10.1016/j.jclinepi.2020.02.002) (PMID:32105798)

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Abstract

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 DSM (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. Individual participant data meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included. Pooled PHQ-9 ≥ 10 prevalence was 24.6% (95% CI: 20.8%, 28.9%); pooled SCID major depression prevalence was 12.1% (95% CI: 9.6%, 15.2%); pooled difference was 11.9% (95% CI: 9.3%, 14.6%). 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%). PHQ-9 ≥ 10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies. [Abstract copyright: Copyright © 2020 Elsevier Inc. All rights reserved.]

Item Type:Articles
Keywords:PHQ-9, SCID, depression prevalence, individual participant data meta-analysis.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Taylor-Rowan, Dr Martin and Quinn, Professor Terry
Creator Roles:
Quinn, T. J.Data curation, Writing – review and editing
Taylor-Rowan, M.Data curation, Writing – review and editing
Authors: Levis, B., Benedetti, A., Ioannidis, J. P. A., Sun, Y., Negeri, Z., He, C., Wu, Y., Krishnan, A., Bhandari, P. M., Neupane, D., Imran, M., Rice, D. B., Riehm, K. E., Saadat, N., Azar, M., Boruff, J., Cuijpers, P., Gilbody, S., Kloda, L. A., McMillan, D., Patten, S. B., Shrier, I., Ziegelstein, R. C., Alamri, S. H., Amtmann, D., Ayalon, L., Baradaran, H. R., Beraldi, A., Bernstein, C. N., Bhana, A., Bombardier, C. H., Carter, G., Chagas, M. H., Chibanda, D., Clover, K., Conwell, Y., Diez-Quevedo, C., Fann, J. R., Fischer, F. H., Gholizadeh, L., Gibson, L. J., Green, E. P., Greeno, C. G., Hall, B. J., Haroz, E. E., Ismail, K., Jetté, N., Khamseh, M. E., Kwan, Y., Lara, M. A., Liu, S.-I., Loureiro, S. R., Löwe, B., Marrie, R. A., Marsh, L., McGuire, A., Muramatsu, K., Navarrete, L., Osório, F. L., Petersen, I., Picardi, A., Pugh, S. L., Quinn, T. J., Rooney, A. G., Shinn, E. H., Sidebottom, A., Spangenberg, L., Lynnette Tan, P. L., Taylor-Rowan, M., Turner, A., van Weert, H. C., Vöhringer, P. A., Wagner, L. I., White, J., Winkley, K., and Thombs, B. D.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Journal of Clinical Epidemiology
Publisher:Elsevier
ISSN:0895-4356
ISSN (Online):1878-5921
Published Online:24 February 2020
Copyright Holders:Copyright © 2020 Elsevier Inc.
First Published:First published in Journal of Clinical Epidemiology 122: 115-128.e1
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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