Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
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ABSTRACT: Background
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.Methods
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.Results
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).Conclusions
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
SUBMITTER: Wu Y
PROVIDER: S-EPMC6954991 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
Publications
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Wu Yin Y Levis Brooke B Riehm Kira E KE Saadat Nazanin N Levis Alexander W AW Azar Marleine M Rice Danielle B DB Boruff Jill J Cuijpers Pim P Gilbody Simon S Ioannidis John P A JPA Kloda Lorie A LA McMillan Dean D Patten Scott B SB Shrier Ian I Ziegelstein Roy C RC Akena Dickens H DH Arroll Bruce B Ayalon Liat L Baradaran Hamid R HR Baron Murray M Bombardier Charles H CH Butterworth Peter P Carter Gregory G Chagas Marcos H MH Chan Juliana C N JCN Cholera Rushina R Conwell Yeates Y de Man-van Ginkel Janneke M JM Fann Jesse R JR Fischer Felix H FH Fung Daniel D Gelaye Bizu B Goodyear-Smith Felicity F Greeno Catherine G CG Hall Brian J BJ Harrison Patricia A PA Härter Martin M Hegerl Ulrich U Hides Leanne L Hobfoll Stevan E SE Hudson Marie M Hyphantis Thomas T Inagaki Masatoshi M Jetté Nathalie N Khamseh Mohammad E ME Kiely Kim M KM Kwan Yunxin Y Lamers Femke F Liu Shen-Ing SI Lotrakul Manote M Loureiro Sonia R SR Löwe Bernd B McGuire Anthony A Mohd-Sidik Sherina S Munhoz Tiago N TN Muramatsu Kumiko K Osório Flávia L FL Patel Vikram V Pence Brian W BW Persoons Philippe P Picardi Angelo A Reuter Katrin K Rooney Alasdair G AG Santos Iná S IS Shaaban Juwita J Sidebottom Abbey A Simning Adam A Stafford Lesley L Sung Sharon S Tan Pei Lin Lynnette PLL Turner Alyna A van Weert Henk C HC White Jennifer J Whooley Mary A MA Winkley Kirsty K Yamada Mitsuhiko M Benedetti Andrea A Thombs Brett D BD
Psychological medicine 20190712 8
<h4>Background</h4>Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.<h4>Methods</h4>We conducted an individual pa ...[more]
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