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1. Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale - Depression subscale scores: An individual participant data meta-analysis of 73 primary studies.

Author

Wu Y, Levis B, Sun Y, Krishnan A, He C, Riehm KE, Rice DB, Azar M, Yan XW, Neupane D, Bhandari PM, Imran M, Chiovitti MJ, Saadat N, Boruff JT, Cuijpers P, Gilbody S, McMillan D, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Tonelli M, Al-Adawi S, Beraldi A, Braeken APBM, Büel-Drabe N, Bunevicius A, Carter G, Chen CK, Cheung G, Clover K, Conroy RM, Cukor D, da Rocha E Silva CE, Dabscheck E, Daray FM, Douven E, Downing MG, Feinstein A, Ferentinos PP, Fischer FH, Flint AJ, Fujimori M, Gallagher P, Gandy M, Goebel S, Grassi L, Härter M, Jenewein J, Jetté N, Julião M, Kim JM, Kim SW, Kjærgaard M, Köhler S, Loosman WL, Löwe B, Martin-Santos R, Massardo L, Matsuoka Y, Mehnert A, Michopoulos I, Misery L, Navines R, O'Donnell ML, Öztürk A, Peceliuniene J, Pintor L, Ponsford JL, Quinn TJ, Reme SE, Reuter K, Rooney AG, Sánchez-González R, Schwarzbold ML, Senturk Cankorur V, Shaaban J, Sharpe L, Sharpe M, Simard S, Singer S, Stafford L, Stone J, Sultan S, Teixeira AL, Tiringer I, Turner A, Walker J, Walterfang M, Wang LJ, White J, Wong DK, Benedetti A, and Thombs BD

Subjects
Female, Humans, Male, Probability, Depressive Disorder, Major diagnosis, Psychiatric Status Rating Scales standards
Abstract

Objective: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D)., Methods: Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed. We fit binomial generalized linear mixed models to compare odds of major depression classification for the Structured Clinical Interview for DSM (SCID), Composite International Diagnostic Interview (CIDI), and Mini International Neuropsychiatric Interview (MINI), controlling for HADS-D scores and participant characteristics with and without an interaction term between interview and HADS-D scores., Results: There were 15,856 participants (1942 [12%] with major depression) from 73 studies, including 15,335 (97%) non-psychiatric medical patients, 164 (1%) partners of medical patients, and 357 (2%) healthy adults. The MINI (27 studies, 7345 participants, 1066 major depression cases) classified participants as having major depression more often than the CIDI (10 studies, 3023 participants, 269 cases) (adjusted odds ratio [aOR] = 1.70 (0.84, 3.43)) and the semi-structured SCID (36 studies, 5488 participants, 607 cases) (aOR = 1.52 (1.01, 2.30)). The odds ratio for major depression classification with the CIDI was less likely to increase as HADS-D scores increased than for the SCID (interaction aOR = 0.92 (0.88, 0.96))., Conclusion: Compared to the SCID, the MINI may diagnose more participants as having major depression, and the CIDI may be less responsive to symptom severity., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2020
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2. Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

Author

Levis B, Benedetti A, Riehm KE, Saadat N, Levis AW, Azar M, Rice DB, Chiovitti MJ, Sanchez TA, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, McMillan D, Patten SB, Shrier I, Steele RJ, Ziegelstein RC, Akena DH, Arroll B, Ayalon L, Baradaran HR, Baron M, Beraldi A, Bombardier CH, Butterworth P, Carter G, Chagas MH, Chan JCN, Cholera R, Chowdhary N, Clover K, Conwell Y, de Man-van Ginkel JM, Delgadillo J, Fann JR, Fischer FH, Fischler B, Fung D, Gelaye B, Goodyear-Smith F, Greeno CG, Hall BJ, Hambridge J, Harrison PA, Hegerl U, Hides L, Hobfoll SE, Hudson M, Hyphantis T, Inagaki M, Ismail K, Jetté N, Khamseh ME, Kiely KM, Lamers F, Liu SI, Lotrakul M, Loureiro SR, Löwe B, Marsh L, McGuire A, Mohd Sidik S, Munhoz TN, Muramatsu K, Osório FL, Patel V, Pence BW, Persoons P, Picardi A, Rooney AG, Santos IS, Shaaban J, Sidebottom A, Simning A, Stafford L, Sung S, Tan PLL, Turner A, van der Feltz-Cornelis CM, van Weert HC, Vöhringer PA, White J, Whooley MA, Winkley K, Yamada M, Zhang Y, and Thombs BD

Subjects
Adult, Depression classification, Depressive Disorder, Major classification, Female, Humans, Interview, Psychological standards, Male, Meta-Analysis as Topic, Probability, Depression diagnosis, Depressive Disorder, Major diagnosis, Interview, Psychological methods, Psychiatric Status Rating Scales standards
Abstract

Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics., Method: Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit., Results: A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97)., Conclusions: The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

Published
2018
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3. Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis

Author

Negeri, Zelalem F, Levis, Brooke, Sun, Ying, He, Chen, Krishnan, Ankur, Wu, Yin, Bhandari, Parash Mani, Neupane, Dipika, Brehaut, Eliana, Benedetti, Andrea, Thombs, Brett D, Imran, Mahrukh, Rice, Danielle B, Riehm, Kira E, Azar, Marleine, Levis, Alexander W, Boruff, Jill T, Cuijpers, Pim, Gilbody, Simon, Ioannidis, John P A, Kloda, Lorie A, Patten, Scott B, Shrier, Ian, Ziegelstein, Roy C, Markham, Sarah, Alamri, Sultan H, Amtmann, Dagmar, Arroll, Bruce, Ayalon, Liat, Baradaran, Hamid R, Beraldi, Anna, Bernstein, Charles N, Bhana, Arvin, Bombardier, Charles H, Buji, Ryna Imma, Butterworth, Peter, Carter, Gregory, Chagas, Marcos H, Chan, Juliana C N, Chan, Lai Fong, Chibanda, Dixon, Clover, Kerrie, Conway, Aaron, Conwell, Yeates, Daray, Federico M, de Man-van Ginkel, Janneke M, Delgadillo, Jaime, Diez-Quevedo, Crisanto, Fann, Jesse R, Fischer, Felix H, Field, Sally, Fisher, Jane R W, Fung, Daniel, Garman, Emily C, Gelaye, Bizu, Gholizadeh, Leila, Gibson, Lorna J, Goodyear-Smith, Felicity, Green, Eric P, Greeno, Catherine G, Hall, Brian J, Hantsoo, Liisa, Haroz, Emily E, Härter, Martin, Hegerl, Ulrich, Hides, Leanne, Hobfoll, Stevan E, Honikman, Simone, Hudson, Marie, Hyphantis, Thomas, Inagaki, Masatoshi, Jeon, Hong Jin, Jetté, Nathalie, Khamseh, Mohammad E, Kӧhler, Sebastian, Kohrt, Brandon A, Kwan, Yunxin, Lamers, Femke, Lara, Maria Asunción, Levin-Aspenson, Holly F, Liu, Shen-Ing, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Luitel, Nagendra P, Lund, Crick, Marrie, Ruth Ann, Marsh, Laura, Marx, Brian P, McGuire, Anthony, Mohd Sidik, Sherina, Munhoz, Tiago N, Muramatsu, Kumiko, Nakku, Juliet E M, Navarrete, Laura, Osório, Flávia L, Pence, Brian W, Persoons, Philippe, Petersen, Inge, Picardi, Angelo, Pugh, Stephanie L, Quinn, Terence J, Rancans, Elmars, Rathod, Sujit D, Reuter, Katrin, Rooney, Alasdair G, Rowe, Heather J, Santos, Iná S, Schram, Miranda T, Shaaban, Juwita, Shinn, Eileen H, Sidebottom, Abbey, Simning, Adam, Spangenberg, Lena, Stafford, Lesley, Sung, Sharon C, Suzuki, Keiko, Tan, Pei Lin Lynnette, Taylor-Rowan, Martin, Tran, Thach D, Turner, Alyna, van der Feltz-Cornelis, Christina M, van Heyningen, Thandi, van Weert, Henk C, Vöhringer, Paul A, Wagner, Lynne I, Wang, Jian Li, Wang, Wenzheng, Watson, David, White, Jennifer, Whooley, Mary A, Winkley, Kirsty, Wynter, Karen, Yamada, Mitsuhiko, Zeng, Qing Zhi, and Zhang, Yuying

Subjects
Adult, Male, medicine.medical_specialty, MEDLINE, PsycINFO, Patient Health Questionnaire, Sex Factors, Medicine, Humans, Mini-international neuropsychiatric interview, Psychiatric Status Rating Scales, Depressive Disorder, Major, business.industry, Research, Age Factors, General Medicine, Middle Aged, Reference Standards, Random effects model, Confidence interval, ROC Curve, Meta-analysis, Family medicine, Structured interview, Female, business
Abstract

ObjectiveTo update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression overall and by study or participant subgroups.DesignSystematic review and individual participant data meta-analysis.Data sourcesMedline, Medline In-Process, and Other Non-Indexed Citations via Ovid, PsycINFO, Web of Science searched through 9 May 2018.Review methodsEligible studies administered the PHQ-9 and classified current major depression status using a validated semistructured diagnostic interview (designed for clinician administration), fully structured interview (designed for lay administration), or the Mini International Neuropsychiatric Interview (MINI; a brief interview designed for lay administration). A bivariate random effects meta-analytic model was used to obtain point and interval estimates of pooled PHQ-9 sensitivity and specificity at cut-off values 5-15, separately, among studies that used semistructured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual), fully structured interviews (eg, Composite International Diagnostic Interview), and the MINI. Meta-regression was used to investigate whether PHQ-9 accuracy correlated with reference standard categories and participant characteristics.ResultsData from 44 503 total participants (27 146 additional from the update) were obtained from 100 of 127 eligible studies (42 additional studies; 79% eligible studies; 86% eligible participants). Among studies with a semistructured interview reference standard, pooled PHQ-9 sensitivity and specificity (95% confidence interval) at the standard cut-off value of ≥10, which maximised combined sensitivity and specificity, were 0.85 (0.79 to 0.89) and 0.85 (0.82 to 0.87), respectively. Specificity was similar across reference standards, but sensitivity in studies with semistructured interviews was 7-24% (median 21%) higher than with fully structured reference standards and 2-14% (median 11%) higher than with the MINI across cut-off values. Across reference standards and cut-off values, specificity was 0-10% (median 3%) higher for men and 0-12 (median 5%) higher for people aged 60 or older.ConclusionsResearchers and clinicians could use results to determine outcomes, such as total number of positive screens and false positive screens, at different PHQ-9 cut-off values for different clinical settings using the knowledge translation tool atwww.depressionscreening100.com/phq.Study registrationPROSPERO CRD42014010673.

Published
2021

4. Accuracy of the Hospital Anxiety and Depression Scale Depression subscale (HADS-D) to screen for major depression: systematic review and individual participant data meta-analysis

Author

Andrea Benedetti, Yin Wu, Ying Sun, Brooke Levis, Ankur Krishnan, Chen He, Zelalem Negeri, Brett D. Thombs, Parash Mani Bhandari, Dipika Neupane, Riehm, Kira E, Rice, Danielle B, Azar, Marleine, Yan, Xin Wei, Imran, Mahrukh, Chiovitti, Matthew J, Saadat, Nazanin, Boruff, Jill T, Cuijpers, Pim, Gilbody, Simon, Ioannidis, John P A, Kloda, Lorie A, Patten, Scott B, Ziegelstein, Roy C, Markham, Sarah, Henry, Melissa, Ismail, Zahinoor, Loiselle, Carmen G, Mitchell, Nicholas D, Tonelli, Marcello, Al-Adawi, Samir, Beck, Kevin R, Beraldi, Anna, Bernstein, Charles N, Boye, Birgitte, Büel-Drabe, Natalie, Bunevičius, Adomas, Can, Ceyhun, Carter, Gregory, Chen, Chih-Ken, Cheung, Gary, Clover, Kerrie, Costa-Requena, Gema, Cukor, Daniel, Dabscheck, Eli, Daray, Federico M, De Souza, Jennifer, Dorow, Marie, Downing, Marina G, Feinstein, Anthony, Ferentinos, Panagiotis P, Fischer, Felix H, Flint, Alastair J, Fujimori, Maiko, Gallagher, Pamela, Gandy, Milena, Grassi, Luigi, Härter, Martin, Hernando, Asuncion, Jenewein, Josef, Jetté, Nathalie, Julião, Miguel, Keller, Monika, Kim, Sung-Wan, Kjærgaard, Marie, Köhler, Sebastian, König, Hans-Helmut, Krishna, Lalit K R, Lee, Yu, Löbner, Margrit, Loosman, Wim L, Love, Anthony W, Löwe, Bernd, Malt, Ulrik F, Marrie, Ruth Ann, Martin-Santos, Rocio, Massardo, Loreto, Matsuoka, Yutaka, Mehnert, Anja, Michopoulos, Ioannis, Misery, Laurent, Navines, Ricard, Nelson, Christian J, Ng, Chong Guan, O'Donnell, Meaghan L, O'Rourke, Suzanne J, Öztürk, Ahmet, Pabst, Alexander, Pasco, Julie A, Pečeliūnienė, Jūratė, Pintor, Luis, Ponsford, Jennie L, Pulido, Federico, Quinn, Terence J, Reme, Silje E, Reuter, Katrin, Rieckmann, Nina, Riedel-Heller, Steffi G, Rooney, Alasdair G, Sánchez-González, Roberto, Saracino, Rebecca M, Schellekens, Melanie P J, Scherer, Martin, Schwarzbold, Marcelo L, Senturk Cankorur, Vesile, Shaaban, Juwita, Sharpe, Louise, Sharpe, Michael, Simard, Sébastien, Singer, Susanne, Stafford, Lesley, Stone, Jon, Strobel, Natalie A, Sultan, Serge, Teixeira, Antonio L, Tiringer, Istvan, Tschorn, Mira, Tung, Ka-Yee, Turner, Alyna, Wagner, Michael, Walker, Jane, Walterfang, Mark, Wang, Liang-Jen, Weyerer, Siegfried B, White, Jennifer, Williams, Lana J, Wong, Lai-Yi, and Group, DEPRESsion Screening Data (DEPRESSD) HADS

Subjects
Psychometrics, MEDLINE, LS5_12, Hospital Anxiety and Depression Scale, Corrections, Sensitivity and Specificity, NO, 03 medical and health sciences, 0302 clinical medicine, purl.org/becyt/ford/3.2 [https], Humans, Medicine, 030212 general & internal medicine, Depression (differential diagnoses), HADS- D, metaanalysis, accuracy, Mini-international neuropsychiatric interview, Psychiatric Status Rating Scales, HADS-D, Depressive Disorder, Major, Depressive Disorder, Diagnostic and Statistical Manual of Mental Disorders, Hospitalization, business.industry, Research, Major, General Medicine, Confidence interval, 030227 psychiatry, Meta-analysis, Structured interview, purl.org/becyt/ford/3 [https], business, Clinical psychology
Abstract

Objective To evaluate the accuracy of the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) to screen for major depression among people with physical health problems. Design Systematic review and individual participant data meta-analysis. Data sources Medline, Medline In-Process and Other Non-Indexed Citations, PsycInfo, and Web of Science (from inception to 25 October 2018). Review methods Eligible datasets included HADS-D scores and major depression status based on a validated diagnostic interview. Primary study data and study level data extracted from primary reports were combined. For HADS-D cut-off thresholds of 5-15, a bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, in studies that used semi-structured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders), fully structured interviews (eg, Composite International Diagnostic Interview), and the Mini International Neuropsychiatric Interview. One stage meta-regression was used to examine whether accuracy was associated with reference standard categories and the characteristics of participants. Sensitivity analyses were done to assess whether including published results from studies that did not provide raw data influenced the results. Results Individual participant data were obtained from 101 of 168 eligible studies (60%; 25 574 participants (72% of eligible participants), 2549 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of seven or higher for semi-structured interviews, fully structured interviews, and the Mini International Neuropsychiatric Interview. Among studies with a semi-structured interview (57 studies, 10 664 participants, 1048 with major depression), sensitivity and specificity were 0.82 (95% confidence interval 0.76 to 0.87) and 0.78 (0.74 to 0.81) for a cut-off value of seven or higher, 0.74 (0.68 to 0.79) and 0.84 (0.81 to 0.87) for a cut-off value of eight or higher, and 0.44 (0.38 to 0.51) and 0.95 (0.93 to 0.96) for a cut-off value of 11 or higher. Accuracy was similar across reference standards and subgroups and when published results from studies that did not contribute data were included. Conclusions When screening for major depression, a HADS-D cut-off value of seven or higher maximised combined sensitivity and specificity. A cut-off value of eight or higher generated similar combined sensitivity and specificity but was less sensitive and more specific. To identify medically ill patients with depression with the HADS-D, lower cut-off values could be used to avoid false negatives and higher cut-off values to reduce false positives and identify people with higher symptom levels. Fil: Wu, Yin. School Of Medicine; Canadá. Lady Davis Institute For Medical Research; Canadá Fil: Levis, Brooke. Keele University; Reino Unido Fil: Sun, Ying. Lady Davis Institute For Medical Research; Canadá Fil: He, Chen. Lady Davis Institute For Medical Research; Canadá Fil: Krishnan, Ankur. Lady Davis Institute For Medical Research; Canadá Fil: Neupane, Dipika. Lady Davis Institute For Medical Research; Canadá Fil: Bhandari, Parash Mani. Lady Davis Institute For Medical Research; Canadá Fil: Negeri, Zelalem. Université Mcgill; Canadá. Lady Davis Institute For Medical Research; Canadá Fil: Benedetti, Andrea. Centre Universitaire de Santé Mcgill; Canadá Fil: Thombs, Brett D.. Mcgill Faculty Of Medicine And Health Sciences; Canadá. Lady Davis Institute For Medical Research; Canadá Fil: Daray, Federico Manuel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina

Published
2021

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