The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

doi:10.1159/000502294

Meta-Analysis

. 2020;89(1):25-37.

doi: 10.1159/000502294. Epub 2019 Oct 8.

The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

Chen He^{1

2}, Brooke Levis^{1

2}, Kira E Riehm¹, Nazanin Saadat¹, Alexander W Levis^{1

2}, Marleine Azar^{1

2}, Danielle B Rice^{1

3}, Ankur Krishnan¹, Yin Wu^{1

2

4}, Ying Sun¹, Mahrukh Imran¹, Jill Boruff⁵, Pim Cuijpers⁶, Simon Gilbody⁷, John P A Ioannidis⁸, Lorie A Kloda⁹, Dean McMillan⁷, Scott B Patten^{10

11}, Ian Shrier^{1

2}, Roy C Ziegelstein¹², Dickens H Akena¹³, Bruce Arroll¹⁴, Liat Ayalon¹⁵, Hamid R Baradaran^{16

17}, Murray Baron^{1

18}, Anna Beraldi¹⁹, Charles H Bombardier²⁰, Peter Butterworth^{21

22}, Gregory Carter²³, Marcos Hortes Nisihara Chagas²⁴, Juliana C N Chan^{24

25

26}, Rushina Cholera²⁷, Kerrie Clover^{23

28}, Yeates Conwell²⁹, Janneke M de Man-van Ginkel³⁰, Jesse R Fann³¹, Felix H Fischer³², Daniel Fung^{33

34

35

36}, Bizu Gelaye³⁷, Felicity Goodyear-Smith¹⁴, Catherine G Greeno³⁸, Brian J Hall^{39

40}, Patricia A Harrison⁴¹, Martin Härter⁴², Ulrich Hegerl⁴³, Leanne Hides⁴⁴, Stevan E Hobfoll⁴⁵, Marie Hudson^{1

18}, Thomas N Hyphantis⁴⁶, Masatoshi Inagaki⁴⁷, Khalida Ismail⁴⁸, Nathalie Jetté^{10

11

49}, Mohammad E Khamseh¹⁶, Kim M Kiely^{50

51}, Yunxin Kwan⁵², Femke Lamers⁵³, Shen-Ing Liu^{36

54

55

56}, Manote Lotrakul⁵⁷, Sonia R Loureiro⁴⁹, Bernd Löwe⁵⁸, Laura Marsh⁵⁹, Anthony McGuire⁶⁰, Sherina Mohd-Sidik⁶¹, Tiago N Munhoz⁶², Kumiko Muramatsu⁶³, Flávia L Osório^{49

64}, Vikram Patel^{65

66}, Brian W Pence⁶⁷, Philippe Persoons^{68

69}, Angelo Picardi⁷⁰, Katrin Reuter⁷¹, Alasdair G Rooney⁷², Iná S da Silva Dos Santos⁶², Juwita Shaaban⁷³, Abbey Sidebottom⁷⁴, Adam Simning²⁹, Lesley Stafford^{75

76}, Sharon Sung^{33

36}, Pei Lin Lynnette Tan⁵², Alyna Turner^{77

78}, Henk C P M van Weert⁷⁹, Jennifer White⁸⁰, Mary A Whooley^{81

82

83}, Kirsty Winkley⁸⁴, Mitsuhiko Yamada⁸⁵, Brett D Thombs^{86

87

88

89

90

91}, Andrea Benedetti^{2

18

92}

Affiliations

¹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
² Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
³ Department of Psychology, McGill University, Montréal, Québec, Canada.
⁴ Department of Psychiatry, McGill University, Montréal, Québec, Canada.
⁵ Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montreal, Québec, Canada.
⁶ Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
⁷ Hull York Medical School and the Department of Health Sciences, University of York, Heslington, United Kingdom.
⁸ Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, California, USA.
⁹ Library, Concordia University, Montréal, Québec, Canada.
¹⁰ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹¹ Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
¹² Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹³ Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda.
¹⁴ Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
¹⁵ Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
¹⁶ Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
¹⁷ Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom.
¹⁸ Department of Medicine, McGill University, Montréal, Québec, Canada.
¹⁹ Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Lehrkrankenhaus der Technischen Universität München, Munich, Germany.
²⁰ Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
²¹ Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia.
²² Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Victoria, Australia.
²³ Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia.
²⁴ Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
²⁵ Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR, China.
²⁶ Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China.
²⁷ Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
²⁸ Psycho-Oncology Service, Calvary Mater Newcastle, Newcastle, New South Wales, Australia.
²⁹ Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
³⁰ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
³¹ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.
³² Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
³³ Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore.
³⁴ Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³⁵ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
³⁶ Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
³⁷ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
³⁸ School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³⁹ Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macau SAR, China.
⁴⁰ Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴¹ City of Minneapolis Health Department, Minneapolis, Minnesota, USA.
⁴² Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴³ Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, German Depression Foundation, Frankfurt, Germany.
⁴⁴ School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
⁴⁵ STAR-Stress, Anxiety and Resilience Consultants, Chicago, Illinois, USA.
⁴⁶ Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
⁴⁷ Department of Psychiatry, Faculty of Medicine, Shimane University, Shimane, Japan.
⁴⁸ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London Weston Education Centre, London, United Kingdom.
⁴⁹ Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵⁰ School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
⁵¹ Neuroscience Research Australia, Sydney, New South Wales, Australia.
⁵² Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
⁵³ Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
⁵⁴ Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
⁵⁵ Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
⁵⁶ Department of Medicine, Mackay Medical College, Taipei, Taiwan.
⁵⁷ Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
⁵⁸ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁵⁹ Baylor College of Medicine Houston and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
⁶⁰ Department of Nursing, St. Joseph's College, Standish, Maine, USA.
⁶¹ Cancer Resource and Education Centre, and Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
⁶² Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
⁶³ Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Niigata, Japan.
⁶⁴ National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil.
⁶⁵ Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
⁶⁶ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
⁶⁷ Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁶⁸ Department of Adult Psychiatry, University Hospitals Leuven, Leuven, Belgium.
⁶⁹ Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium.
⁷⁰ Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy.
⁷¹ Practice for Psychotherapy and Psycho-Oncology, Freiburg, Germany.
⁷² Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburg, Edinburgh, United Kingdom.
⁷³ Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
⁷⁴ Allina Health, Minneapolis, Minnesota, USA.
⁷⁵ Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia.
⁷⁶ Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.
⁷⁷ School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
⁷⁸ IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia.
⁷⁹ Department of General Practice, Amsterdam Institute for General Practice and Public Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
⁸⁰ Monash University, Melbourne, Victoria, Australia.
⁸¹ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
⁸² Department of Medicine, Veterans Affairs Medical Center, San Francisco, California, USA.
⁸³ Department of Medicine, University of California San Francisco, San Francisco, California, USA.
⁸⁴ Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
⁸⁵ Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
⁸⁶ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁸⁷ Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁸⁸ Department of Psychology, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁸⁹ Department of Psychiatry, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁹⁰ Department of Medicine, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁹¹ Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁹² Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.

PMID: 31593971
PMCID: PMC6960351
DOI: 10.1159/000502294

Meta-Analysis

The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

Chen He et al. Psychother Psychosom. 2020.

. 2020;89(1):25-37.

doi: 10.1159/000502294. Epub 2019 Oct 8.

Authors

Affiliations

¹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
² Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
³ Department of Psychology, McGill University, Montréal, Québec, Canada.
⁴ Department of Psychiatry, McGill University, Montréal, Québec, Canada.
⁵ Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montreal, Québec, Canada.
⁶ Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
⁷ Hull York Medical School and the Department of Health Sciences, University of York, Heslington, United Kingdom.
⁸ Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, California, USA.
⁹ Library, Concordia University, Montréal, Québec, Canada.
¹⁰ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹¹ Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
¹² Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹³ Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda.
¹⁴ Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
¹⁵ Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
¹⁶ Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
¹⁷ Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom.
¹⁸ Department of Medicine, McGill University, Montréal, Québec, Canada.
¹⁹ Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Lehrkrankenhaus der Technischen Universität München, Munich, Germany.
²⁰ Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
²¹ Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia.
²² Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Victoria, Australia.
²³ Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia.
²⁴ Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
²⁵ Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR, China.
²⁶ Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China.
²⁷ Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
²⁸ Psycho-Oncology Service, Calvary Mater Newcastle, Newcastle, New South Wales, Australia.
²⁹ Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
³⁰ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
³¹ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.
³² Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
³³ Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore.
³⁴ Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³⁵ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
³⁶ Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
³⁷ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
³⁸ School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³⁹ Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macau SAR, China.
⁴⁰ Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴¹ City of Minneapolis Health Department, Minneapolis, Minnesota, USA.
⁴² Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴³ Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, German Depression Foundation, Frankfurt, Germany.
⁴⁴ School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
⁴⁵ STAR-Stress, Anxiety and Resilience Consultants, Chicago, Illinois, USA.
⁴⁶ Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
⁴⁷ Department of Psychiatry, Faculty of Medicine, Shimane University, Shimane, Japan.
⁴⁸ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London Weston Education Centre, London, United Kingdom.
⁴⁹ Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵⁰ School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
⁵¹ Neuroscience Research Australia, Sydney, New South Wales, Australia.
⁵² Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
⁵³ Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
⁵⁴ Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
⁵⁵ Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
⁵⁶ Department of Medicine, Mackay Medical College, Taipei, Taiwan.
⁵⁷ Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
⁵⁸ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁵⁹ Baylor College of Medicine Houston and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
⁶⁰ Department of Nursing, St. Joseph's College, Standish, Maine, USA.
⁶¹ Cancer Resource and Education Centre, and Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
⁶² Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
⁶³ Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Niigata, Japan.
⁶⁴ National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil.
⁶⁵ Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
⁶⁶ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
⁶⁷ Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁶⁸ Department of Adult Psychiatry, University Hospitals Leuven, Leuven, Belgium.
⁶⁹ Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium.
⁷⁰ Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy.
⁷¹ Practice for Psychotherapy and Psycho-Oncology, Freiburg, Germany.
⁷² Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburg, Edinburgh, United Kingdom.
⁷³ Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
⁷⁴ Allina Health, Minneapolis, Minnesota, USA.
⁷⁵ Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia.
⁷⁶ Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.
⁷⁷ School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
⁷⁸ IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia.
⁷⁹ Department of General Practice, Amsterdam Institute for General Practice and Public Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
⁸⁰ Monash University, Melbourne, Victoria, Australia.
⁸¹ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
⁸² Department of Medicine, Veterans Affairs Medical Center, San Francisco, California, USA.
⁸³ Department of Medicine, University of California San Francisco, San Francisco, California, USA.
⁸⁴ Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
⁸⁵ Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
⁸⁶ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁸⁷ Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁸⁸ Department of Psychology, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁸⁹ Department of Psychiatry, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁹⁰ Department of Medicine, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁹¹ Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada, brett.thombs@mcgill.ca.
⁹² Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.

PMID: 31593971
PMCID: PMC6960351
DOI: 10.1159/000502294

Abstract

Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.

Objective: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.

Methods: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview.

Results: Data were included for 54 of 72 identified eligible studies (n participants = 16,688, n cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22-0.24 lower compared to fully structured interviews and 0.06-0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of ≥10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82-0.92) and 0.86 (0.82-0.88).

Conclusions: The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.

Keywords: Depression; Diagnostic accuracy; Meta-analysis; Patient Health Questionnaire-9; Screening.

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Conflict of interest statement

Statement of Ethics: The authors have no ethical conflicts to disclose

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References

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[1] Raffle A, Gray M. Screening: evidence and practice. London (UK): Oxford University Press; 2007.

[2] Raffle A, Gray M. Screening: evidence and practice. London (UK): Oxford University Press; 2007.

[3] Wilson JM, Jungner G. Principles and practices of screening for disease. Geneva: World Health Organization; 1968.

[4] Wilson JM, Jungner G. Principles and practices of screening for disease. Geneva: World Health Organization; 1968.

[5] Fava GA, Tomba E, Sonino N. Clinimetrics: the science of clinical measurements. Int J Clin Pract. 2012;66(1):11–15. - PubMed

[6] Fava GA, Tomba E, Sonino N. Clinimetrics: the science of clinical measurements. Int J Clin Pract. 2012;66(1):11–15. - PubMed

[7] Fava GA, Carrozzino D, Lindberg L, Tomba E. The clinimetric approach to psychological assessment: a tribute to Per Bech, MD (1942-2018). Psychother Psychosom. 2018;87(6):321–326. - PubMed

[8] Fava GA, Carrozzino D, Lindberg L, Tomba E. The clinimetric approach to psychological assessment: a tribute to Per Bech, MD (1942-2018). Psychother Psychosom. 2018;87(6):321–326. - PubMed

[9] Tomba E, Bech P. Clinimetrics and clinical psychometrics: macro- and micro-analysis. Psychother Psychosom. 2012;81(6):333–343. - PubMed

[10] Tomba E, Bech P. Clinimetrics and clinical psychometrics: macro- and micro-analysis. Psychother Psychosom. 2012;81(6):333–343. - PubMed

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The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

Affiliations

The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

Authors

Affiliations

Abstract

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Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical