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

Brooke Levis; Andrea Benedetti; John P. A. Ioannidis; Ying Sun; Zelalem Negeri; Chen He; Yin Wu; Ankur Krishnan; Parash Mani Bhandari; Dipika Neupane; Mahrukh Imran; Danielle B. Rice; Kira E. Riehm; Nazanin Saadat; Marleine Azar; Jill Boruff; Pim Cuijpers; Simon Gilbody; Lorie A. Kloda; Dean McMillan; Scott B. Patten; Ian Shrier; Roy C. Ziegelstein; Sultan H. Alamri; Dagmar Amtmann; Liat Ayalon; Hamid R. Baradaran; Anna Beraldi; Charles N. Bernstein; Arvin Bhana; Charles H. Bombardier; Gregory Carter; Marcos H. Chagas; Dixon Chibanda; Kerrie Clover; Yeates Conwell; Crisanto Diez-Quevedo; Jesse R. Fann; Felix H. Fischer; Leila Gholizadeh; Lorna J. Gibson; Eric P. Green; Catherine G. Greeno; Brian J. Hall; Emily E. Haroz; Khalida Ismail; Nathalie Jette; Mohammad E. Khamseh; Yunxin Kwan; Maria Asuncion Lara; Shen-Ing Liu; Sonia R. Loureiro; Bernd Loewe; Ruth Ann Marrie; Laura Marsh; Anthony McGuire; Kumiko Muramatsu; Laura Navarrete; Flavia L. Osorio; Inge Petersen; Angelo Picardi; Stephanie L. Pugh; Terence J. Quinn; Alasdair G. Rooney; Eileen H. Shinn; Abbey Sidebottom; Lena Spangenberg; Pei Lin Lynnette Tan; Martin Taylor-Rowan; Alyna Turner; Henk C. van Weert; Paul A. Voehringer; Lynne Wagner; Jennifer White; Kirsty Winkley; Brett D. Thombs

doi:10.1016/j.jclinepi.2020.02.002

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

Journal article

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

Brooke Levis, Andrea Benedetti, John P. A. Ioannidis, Ying Sun, Zelalem Negeri, Chen He, Yin Wu, Ankur Krishnan, Parash Mani Bhandari, Dipika Neupane, …

Journal of clinical epidemiology, Vol.122, pp.115-128.e1

01/06/2020

DOI: https://doi.org/10.1016/j.jclinepi.2020.02.002

PMID: 32105798

Abstract

Health Care Sciences & Services

Life Sciences & Biomedicine

Public, Environmental & Occupational Health

Science & Technology

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. (C) 2020 Elsevier Inc. All rights reserved.

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Title: Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis
Creators - without role: Brooke Levis - Jewish General Hospital
Andrea Benedetti - McGill University
John P. A. Ioannidis - Stanford University
Ying Sun - College Station Medical Center
Zelalem Negeri - McGill University
Chen He - Jewish General Hospital
Yin Wu - McGill University
Ankur Krishnan - Jewish General Hospital
Parash Mani Bhandari - McGill University
Dipika Neupane - McGill University
Mahrukh Imran - Jewish General Hospital
Danielle B. Rice - Jewish General Hospital
Kira E. Riehm - Jewish General Hospital
Nazanin Saadat - Jewish General Hospital
Marleine Azar - Jewish General Hospital
Jill Boruff - McGill University
Pim Cuijpers - Vrije Universiteit Amsterdam
Simon Gilbody - Hull York Medical School
Lorie A. Kloda - Concordia University
Dean McMillan - Bloomberg
Scott B. Patten - University of Calgary
Ian Shrier - Jewish General Hospital
Roy C. Ziegelstein - Johns Hopkins Medicine
Sultan H. Alamri - King Abdulaziz University
Dagmar Amtmann - University of Washington
Liat Ayalon - Bar-Ilan University
Hamid R. Baradaran - Iran University of Medical Sciences
Anna Beraldi - Lehrkrankenhaus Techn Univ Munchen, Klin Psychiat Psychotherapie & Psychosomat, Kbo Lech Mangfall Klin Garm Partenkirchen, Munich, Germany
Charles N. Bernstein - University of Manitoba
Arvin Bhana - University of KwaZulu-Natal
Charles H. Bombardier - University of Washington
Gregory Carter - University of Newcastle Australia
Marcos H. Chagas - Universidade de São Paulo
Dixon Chibanda - University of Zimbabwe
Kerrie Clover - University of Newcastle Australia
Yeates Conwell - University of Rochester Medical Center
Crisanto Diez-Quevedo - Hospital Universitari Germans Trias i Pujol
Jesse R. Fann - University of Washington
Felix H. Fischer - McGill University
Leila Gholizadeh - University of Technology Sydney
Lorna J. Gibson - London School of Hygiene & Tropical Medicine
Eric P. Green - Duke University
Catherine G. Greeno - University of Pittsburgh
Brian J. Hall - Bloomberg
Emily E. Haroz - Bloomberg
Khalida Ismail - King's College London
Nathalie Jette - University of Calgary
Mohammad E. Khamseh - Iran University of Medical Sciences
Yunxin Kwan - Tan Tock Seng Hospital
Maria Asuncion Lara - Inst Nacl Psiquiatria Ramon de la Fuente Muniz, Mexico City, DF, Mexico
Shen-Ing Liu - Duke-NUS Medical School
Sonia R. Loureiro - Universidade de São Paulo
Bernd Loewe - Univ Med Ctr Hamburg Eppendorf, Dept Psychosomat Med & Psychotherapy, Hamburg, Germany
Ruth Ann Marrie - University of Manitoba
Laura Marsh - Michael E. DeBakey VA Medical Center
Anthony McGuire - St Josephs Coll, Dept Nursing, Standish, ME USA
Kumiko Muramatsu - Niigata Seiryo University
Laura Navarrete - Instituto Nacional de Psiquiatría
Flavia L. Osorio - Supreme Council Of Health
Inge Petersen - University of KwaZulu-Natal
Angelo Picardi - Istituto Superiore di Sanità
Stephanie L. Pugh - NRG Oncology
Terence J. Quinn - University of Glasgow
Alasdair G. Rooney - Royal Edinburgh Hospital
Eileen H. Shinn - The University of Texas MD Anderson Cancer Center
Abbey Sidebottom - Allina Health
Lena Spangenberg - Leipzig University
Pei Lin Lynnette Tan - College Station Medical Center
Martin Taylor-Rowan - University of Glasgow
Alyna Turner - University of Newcastle Australia
Henk C. van Weert - Amsterdam University Medical Centers
Paul A. Voehringer - University of Chile
Lynne Wagner - Wake Forest University
Jennifer White - Monash University
Kirsty Winkley - King's College London
Brett D. Thombs - Jewish General Hospital
Publication Details: Journal of clinical epidemiology, Vol.122, pp.115-128.e1
Publisher: Elsevier
Number of pages: 15
Grant note: RP-PG0606-1142 / UK National Institute for Health Research under its Programme Grants for Applied Research Programme TL1 RR024135 / National Center for Research Resources; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) Research Manitoba Chair University of Technology Sydney MYRG-2014-111 / Macao (SAR) Government, through the University of Macau RSKTO grants 301321/2016-7 / Productivity Grants (PQ-CNPq-2) T32 GM07356 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA 97/1184 / Spanish Ministry of Health's Health Research Fund (Fondo de Investigaciones Sanitarias) Lance Armstrong Foundation Niigata Seiryo University Fonds de recherche du Quebec -Sante (FRQS) Postdoctoral Training Fellowships Waugh Family Chair in Multiple Sclerosis CIHR; Canadian Institutes of Health Research (CIHR) Lundbeck International Pennsylvania Department of Health R40MC07840 / United States Department of Health and Human Services, Health Resources and Services Administration; United States Department of Health & Human Services; United States Health Resources & Service Administration (HRSA) MB 0008 / National Multiple Sclerosis Society THC-135234 / CIHR; Canadian Institutes of Health Research (CIHR) 121/2000 / medical faculty of the University of Heidelberg, Germany 09.1.01689.17.7 / Reitoria de Pesquisa da Universidade de Sao Paulo 0087-04 / Grand Challenges Canada; CGIAR FRQS Academic Medical Center/University of Amsterdam Alberta Innovates Health Solutions Research Manitoba Chair in Multiple Sclerosis M-288 / Tehran University of Medical Sciences CIHR Frederick Banting and Charles Best Canada Graduate Scholarship master's awards; Canadian Institutes of Health Research (CIHR) Crohn's and Colitis Canada KRS-134297; PCG155468; PJT-162206 / Canadian Institutes of Health Research (CIHR) CB-2009133923-H / Consejo Nacional de Ciencia y Tecnologia/National Council for Science and Technology; Consejo Nacional de Ciencia y Tecnologia (CONACyT) Alberta Health Services through the Calgary Health Trust medical faculty, University of Leipzig AIHS Population Health Investigator Award G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University 453-0751 / Duke Global Health Institute NHRI-EX97-9706PI / National Health Research Institute, Republic of China; National Health Research Institutes - Taiwan H133B080025 / Department of Education (NIDRR) H133N060003 / Baylor College of Medicine Research Institute of the McGill University Health Centre Bingham Chair in Gastroenterology R49 CE002093 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA Italian Ministry of Health; Ministry of Health, Italy United Kingdom National Health Service Lothian Neuro-Oncology Endowment Fund Hotchkiss Brain Institute H133N060033 / Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: University of Washington RO1 HD39415 / US National Center for Medical Rehabilitation Research 201446 / UK Department for International Development R36 HS018246 / Agency for Healthcare Research and Quality; United States Department of Health & Human Services; Agency for Healthcare Research & Quality IS130005 / Fund for Innovation and Competitiveness of the Chilean Ministry of Economy, Development and Tourism, through the Millennium Scientific Initiative Hunter Medical Research Institute U10CA21661; U10CA180868; U10CA180822; U10CA37422 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) Pfizer, Germany; Pfizer R24MH071604; R34 MH072925; K02 MH65919; P30 DK50456; R24 MH56858; RO1-MH069666; R24 MH071604; MH014592-38; MH103210 / NIMH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) 100.003.005; 100.002.021 / Netherlands Organization for Health Research and Development (ZonMw) Mental Health Program AID-DFD A-00-08-00308 / United States Agency for International Development Victims of Torture Fund; United States Agency for International Development (USAID) Cumming School of Medicine, University of Calgary 01GY1150 / German Federal Ministry of Education and Research; Federal Ministry of Education & Research (BMBF) MR/J000914/1 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) Vanier Canada Graduate Scholarship 10.1.01232.17.9 / Banco Santander Canada Research Chair in Neurological Health Services Research K07 CA 093512 / NCI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) H133N060032 / University of Michigan; University of Michigan System
Identifiers: 9937057708331
Academic Unit: Taif University
Language: English
Resource Type: Journal article