In:
Psychotherapy and Psychosomatics, S. Karger AG, Vol. 89, No. 1 ( 2020), p. 25-37
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Data were included for 54 of 72 identified eligible studies ( 〈 i 〉 n 〈 /i 〉 participants = 16,688, 〈 i 〉 n 〈 /i 〉 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). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.
Type of Medium:
Online Resource
ISSN:
0033-3190
,
1423-0348
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1472321-9
SSG:
5,2
SSG:
15,3
