Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews

Levis, Brooke; Benedetti, Andrea; Riehm, Kira E.; Saadat, Nazanin; Levis, Alexander W.; Azar, Marleine; Rice, Danielle B; Chiovitti, Matthew J.; Sanchez, Tatiana A.; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P. A.; ., .; McMillan, Dean; Patten, Scott B.; Shrier, Ian; Steele, Russell; Ziegelstein, Roy C.; Akena, Dickens; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid Reza; Baron, Murray; Beraldi, Anna; Bombardier, Charles H.; Butterworth, Peter; Carter, Gregory; Chagas, Marcos Hortes Nisihara; Chan, Juliana C.N.; Cholera, Rushina; Chowdhary, Neerja; Clover, Kerrie; Conwell, Yeates; Ginkel, Janneke M. de Man‐van; Delgadillo, Jaime; Fann, Jesse R.; Fischer, Felix; Fischler, Benjamin; Fung, Daniel; Gelaye, Bizu; Goodyear‐Smith, Felicity; Greeno, Catherine G.; Hall, Brian J.; Hambridge, John; Harrison, Patricia A.; Hegerl, Ulrich; Hides, Leanne; Hobfoll, Stevan E.; Hudson, Marie; Hyphantis, Thomas; Inagaki, Masumi; Ismail, Khalida; Jetté, Nathalie; Khamseh, Mohammad E.; Kiely, Kim M.; Lamers, Femke; Liu, Shen‐Ing; Lotrakul, Manote; Loureiro, Sônia Regina; Löwe, Bernd; Marsh, Laura; McGuire, Anthony; Sidik, Sherina Mohd; Munhoz, Tiago N.; Muramatsu, Kumiko; Osório, Flávia L.; Patel, Vikram; Pence, Brian W.; Persoons, Philippe; Picardi, Angelo; Rooney, Alasdair G; Santos, Iná S.; Shaaban, Juwita; Sidebottom, Abbey; Simning, Adam; Stafford, Lesley; Sung, So-Young; Tan, Pei Lin Lynnette; Turner, Alyna; Feltz-Cornelis, Christina M. van der; Weert, Henk van; Vöhringer, Paul A.; White, Jennifer; Whooley, Mary A.; Winkley, Kirsty; Yamada, Mitsuhiko; Zhang, Yuying; Thombs, Brett D.

doi:10.1192/bjp.2018.54

Cited by 55 publications

(75 citation statements)

References 32 publications

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“… 8 9 Additional limitations included the inability to assess differences across patient subgroups, as subgroup results were not reported in primary studies; the inability to exclude participants already diagnosed as having or being treated for depression, who would not be screened in practice but were included in many primary studies 10 11 ; and the combining of accuracy estimates without differentiating between reference standards. 12 Semistructured diagnostic interviews (for example, Structured Clinical Interview for DSM Disorders (SCID) 13 ) are intended to be used by experienced diagnosticians and require clinical judgment. Fully structured interviews (for example, Composite International Diagnostic Interview (CIDI) 14 ) are fully scripted and designed to be administered by lay interviewers to reduce the cost of employing trained clinical interviewers; they are intended to achieve a high level of standardization but may sacrifice accuracy.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Levis

Benedetti

Thombs

2019

BMJ

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Objective To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. Design Individual participant data meta-analysis. Data sources Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). Inclusion criteria Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. Results Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. Conclusions PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. Registration PROSPERO CRD42014010673.

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Section: Introductionmentioning

confidence: 99%

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Levis

Benedetti

Thombs

2019

BMJ

Self Cite

1,140

858

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“…Third, depressive symptoms were solicited using a 9‐item symptom checklist (PHQ‐9). It is a well‐known fact that such checklists tend to give spurious results when compared to a gold‐standard interview . It is also still not clear whether noted reactive distress stemming from caring for a differently abled child might constitute healthy coping or otherwise, in light of their circumstances.…”

Section: Discussionmentioning

confidence: 99%

“…It is a well-known fact that such checklists tend to give spurious results when compared to a gold-standard interview. 43 It is also still not clear whether noted reactive distress stemming from caring for a differently abled child might constitute healthy coping or otherwise, in light of their circumstances. In this regard, future studies could contemplate developing ASD-specific integrity of family well-being rather than relying solely on psychiatric nomenclature.…”

Section: Limitationsmentioning

confidence: 99%

Risk factors underlying depressive symptoms among parents/primary care providers of kids with autism spectrum disorder: A study from Muscat, Oman

Alshekaili

Al‐Balushi

Al‐Alawi

et al. 2019

Perspect Psychiatr Care

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Aim To explore the prevalence and correlates of depressive symptoms among parents/primary care providers of children with autism spectrum disorder (ASD). Design and Methods A cross‐sectional analytical study was conducted among a systematic random sample of parents/caregivers of children with diagnosis of ASD in Muscat, Oman. Depressive symptoms were quantified using the Patient Health Questionnaire‐9. Findings The response rate was at 86% (n = 80) and the prevalence of depressive symptoms, at 71.3% (95% confidence interval, 60.5‐80.1). Logistic regression analyses indicated that unemployment and being the sole parent/caregiver in the family were both significant correlates of depressive symptoms. Practice Implications With an increase in the number of children being diagnosed with ASD, multidimensional preventive and remedial service programs for parents/caregivers will be essential.

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“…Fourth, a previous study showed that semistructured and fully structured interviews have different characteristics as reference standards (B. Levis et al, 2018). We excluded studies that used the MINI, given its high rate of diagnosis relative to other diagnostic interviews (B. Levis et al, 2018).…”

Section: Item 9 Ineligible For Inclusion In Short Formsmentioning

confidence: 99%

“…Levis et al, 2018). We excluded studies that used the MINI, given its high rate of diagnosis relative to other diagnostic interviews (B. Levis et al, 2018). We included studies that used both semistructured and fully structured interviews as reference standards, and future work should verify that our results apply in both cases.…”

Section: Item 9 Ineligible For Inclusion In Short Formsmentioning

confidence: 99%

Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4

et al. 2018

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Background: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. Methods: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between 1 and 8 items, including and excluding the 9th item. The final short form was selected based on pre-specified validity, reliability, and diagnostic accuracy criteria. Results: A 4-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach’s alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). Conclusion: The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, pre-specified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.

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Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews

Cited by 55 publications

References 32 publications

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Risk factors underlying depressive symptoms among parents/primary care providers of kids with autism spectrum disorder: A study from Muscat, Oman

Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4

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