Skip to main content
×
×
Home

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

  • Brooke Levis (a1), Andrea Benedetti (a2), Kira E. Riehm (a3), Nazanin Saadat (a3), Alexander W. Levis (a1), Marleine Azar (a1), Danielle B. Rice (a4), Matthew J. Chiovitti (a3), Tatiana A. Sanchez (a3), Pim Cuijpers (a5), Simon Gilbody (a6), John P. A. Ioannidis (a7), Lorie A. Kloda (a8), Dean McMillan (a6), Scott B. Patten (a9), Ian Shrier (a1), Russell J. Steele (a10), Roy C. Ziegelstein (a11), Dickens H. Akena (a12), Bruce Arroll (a13), Liat Ayalon (a14), Hamid R. Baradaran (a15), Murray Baron (a16), Anna Beraldi (a17), Charles H. Bombardier (a18), Peter Butterworth (a19), Gregory Carter (a20), Marcos H. Chagas (a21), Juliana C. N. Chan (a22), Rushina Cholera (a23), Neerja Chowdhary (a24), Kerrie Clover (a25), Yeates Conwell (a26), Janneke M. de Man-van Ginkel (a27), Jaime Delgadillo (a28), Jesse R. Fann (a29), Felix H. Fischer (a30), Benjamin Fischler (a31), Daniel Fung (a32), Bizu Gelaye (a33), Felicity Goodyear-Smith (a13), Catherine G. Greeno (a34), Brian J. Hall (a35), John Hambridge (a36), Patricia A. Harrison (a37), Ulrich Hegerl (a38), Leanne Hides (a39), Stevan E. Hobfoll (a40), Marie Hudson (a16), Thomas Hyphantis (a41), Masatoshi Inagaki (a42), Khalida Ismail (a43), Nathalie Jetté (a44), Mohammad E. Khamseh (a15), Kim M. Kiely (a45), Femke Lamers (a46), Shen-Ing Liu (a47), Manote Lotrakul (a48), Sonia R. Loureiro (a21), Bernd Löwe (a49), Laura Marsh (a50), Anthony McGuire (a51), Sherina Mohd Sidik (a52), Tiago N. Munhoz (a53), Kumiko Muramatsu (a54), Flávia L. Osório (a55), Vikram Patel (a56), Brian W. Pence (a57), Philippe Persoons (a58), Angelo Picardi (a59), Alasdair G. Rooney (a60), Iná S. Santos (a53), Juwita Shaaban (a61), Abbey Sidebottom (a62), Adam Simning (a26), Lesley Stafford (a63), Sharon Sung (a64), Pei Lin Lynnette Tan (a65), Alyna Turner (a66), Christina M. van der Feltz-Cornelis (a67), Henk C. van Weert (a68), Paul A. Vöhringer (a69), Jennifer White (a70), Mary A. Whooley (a71), Kirsty Winkley (a43), Mitsuhiko Yamada (a72), Yuying Zhang (a73) and Brett D. Thombs (a74)...
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.

Aims

To 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 interest

Drs 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.

Copyright
Corresponding author
Correspondence: Brett D. Thombs, PhD, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montréal, Québec H3T 1E4, Canada. Email: brett.thombs@mcgill.ca
References
Hide All
1Jones, KD. The unstructured clinical interview. J Couns Dev 2010; 88: 220–6.
2Brugha, TS, Bebbington, PE, Jenkins, R. A difference that matters: comparisons of structured and semi-structured psychiatric diagnostic interviews in the general population. Psychol Med 1999; 29: 1013–20.
3Nosen, E, Woody, SR. Chapter 8: Diagnostic assessment in research. In Handbook of Research Methods in Abnormal and Clinical Psychology (ed McKay, D). Sage, 2008, pp.109124.
4First, MB. Structured Clinical Interview for the DSM (SCID). John Wiley & Sons, Inc., 1995.
5World Health Organization. Schedules for Clinical Assessment in Neuropsychiatry: Manual. Amer Psychiatric Pub Inc., 1994.
6Kurdyak, PA, Gnam, WH. Small signal, big noise: performance of the CIDI depression module. Can J Psychiatry 2005; 50: 851–6.
7Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, et al. The Composite International Diagnostic Interview: an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988; 45: 1069–77.
8Robins, LN, Helzer, JE, Croughan, J, Ratcliff, KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry 1981; 38: 381–9.
9Lecrubier, Y, Sheehan, DV, Weiller, E, Amorim, P, Bonora, I, Harnett-Sheehan, K, et al. The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 1997; 12: 224–31.
10Sheehan, DV, Lecrubier, Y, Harnett-Sheehan, K, Janavs, J, Weiller, E, Keskiner, A, et al. The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 1997; 12: 232–41.
11Brugha, TS, Jenkins, R, Taub, N, Meltzer, H, Bebbington, PE. A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Psychol Med 2001; 31: 1001–13.
12Rice, DB, Kloda, LA, Shrier, I, Thombs, BD. Reporting completeness and transparency of meta-analyses of depression screening tool accuracy: a comparison of meta-analyses published before and after the PRISMA statement. J Psychosom Res 2016; 87: 5769.
13Anthony, JC, Folstein, M, Romanoski, AJ, Von Korff, MR, Nestadt, GR, Chahal, R, et al. Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis: experience in eastern Baltimore. Arch Gen Psychiatry 1985; 42: 667–75.
14Booth, BM, Kirchner, JA, Hamiltonc, G, Harrell, R, Smith, GR. Diagnosing depression in the medically ill: validity of a lay-administered structured diagnostic interview. J Psychiatr Res 1998; 32: 353–60.
15Hesselbrock, V, Stabenau, J, Hesselbrock, M, Mirkin, P, Meyer, R. A comparison of two interview schedules: the Schedule for Affective Disorders and Schizophrenia-Lifetime and the National Institute for Mental Health Diagnostic Interview Schedule. Arch Gen Psychiatry 1982; 39: 674–7.
16Jordanova, V, Wickramesinghe, C, Gerada, C, Prince, M. Validation of two survey diagnostic interviews among primary care attendees: a comparison of CIS-R and CIDI with SCAN ICD-10 diagnostic categories. Psychol Med 2004; 34: 1013–24.
17Thombs, BD, Benedetti, A, Kloda, LA, Levis, B, Nicolau, I, Cuijpers, P, et al. The diagnostic accuracy of the Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-8 (PHQ-8), and Patient Health Questionnaire-9 (PHQ-9) for detecting major depression: protocol for a systematic review and individual patient data meta-analyses. Syst Rev 2014; 27(3): 124.
18McGowan, J, Sampson, M, Salzwedel, DM, Cogo, E, Foerster, V, Lefebvre, C. PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. J Clin Epidemiol 2016; 75:40–6.
19Sampson, M, Barrowman, NJ, Moher, D, Klassen, TP, Pham, B, Platt, R, et al. Should meta-analysts search Embase in addition to Medline? J Clin Epidemiol 2003; 56: 943–55.
20Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–13.
21Thombs, BD, Arthurs, E, El-Baalbaki, G, Meijer, A, Ziegelstein, RC, Steele, RJ. Risk of bias from inclusion of patients who already have diagnosis of or are undergoing treatment for depression in diagnostic accuracy studies of screening tools for depression: systematic review. BMJ 2011; 343: d4825.
22Diagnostic and statistical manual of mental disorders: DSM-III 3rd ed, revised. Washington, DC: American Psychiatric Association 1987.
23Diagnostic and statistical manual of mental disorders: DSM-IV 4th ed. Washington, DC: American Psychiatric Association 1994.
24Diagnostic and statistical manual of mental disorders: DSM-IV 4th ed, text revised. Washington, DC: American Psychiatric Association 2000.
25The ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines Geneva: World Health Organization 1992.
26United Nations. International Human Development Indicators. UN, 2016 (http://hdr.undp.org/en/countries).
27Whiting, PF, Rutjes, AW, Westwood, ME, Mallett, S, Deeks, JJ, Reitsma, JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155: 529–36.
28Huang, FY, Chung, H, Kroenke, K, Delucchi, KL, Spitzer, RL. Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. J Gen Intern Med 2006; 21: 547–52.
29Martin, A, Rief, W, Klaiberg, A, Braehler, E. Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. Gen Hosp Psychiatry 2006; 28: 717.
30Adewuya, AO, Ola, BA, Afolabi, OO. Validity of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. J Affect Disord 2006; 96: 8993.
31Milette, K, Hudson, M, Baron, M, Thombs, BD. Comparison of the PHQ-9 and CES-D depression scales in systemic sclerosis: internal consistency reliability, convergent validity and clinical correlates. Rheumatology 2010; 49: 789–96.
32Moriarty, AS, Gilbody, S, McMillan, D, Manea, L. Screening and case finding for major depressive disorder using the Patient Health Questionnaire (PHQ-9): a meta-analysis. Gen Hosp Psychiatry 2015; 37: 567–76.
33Thombs, BD, Benedetti, A, Kloda, LA, Levis, B, Riehm, KE, Azar, M, et al. Diagnostic accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for detecting major depression in pregnant and postnatal women: protocol for a systematic review and individual patient data meta-analyses. BMJ Open 2015; 5: e009742.
34Thombs, BD, Benedetti, A, Kloda, LA, Levis, B, Azar, M, Riehm, KE, et al. Diagnostic accuracy of the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for detecting major depression: protocol for a systematic review and individual patient data meta-analyses. BMJ Open 2016; 6: e011913.
35Arthurs, E, Steele, RJ, Hudson, M, Baron, M, Thombs, BD, Canadian Scleroderma Research Group. Are scores on English and French versions of the PHQ-9 comparable? An assessment of differential item functioning. PLoS One 2012; 7: e52028.
36Huang, FY, Chung, H, Kroenke, K, Delucchi, KL, Spitzer, RL. Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. J Gen Intern Med 2006; 21: 547–52.
37Chung, H, Kim, J, Askew, RL, Jones, SMW, Cook, KF, Amtmann, D. Assessing measurement invariance of three depression scales between neurologic samples and community samples. Qual Life Res 2015; 24: 1829–34.
38Cook, KF, Kallen, MA, Bombardier, C, Bamer, AM, Choi, SW, Kim, J, et al. Do measures of depressive symptoms function differently in people with spinal cord injury versus primary care patients: the CES-D, PHQ-9, and PROMIS-D. Qual Lif Res 2017; 26: 139–48.
39Leavens, A, Patten, SB, Hudson, M, Baron, M, Thombs, BD, Canadian Scleroderma Research Group. Influence of somatic symptoms on Patient Health Questionnaire-9 depression scores among patients with systemic sclerosis compared to a healthy general population sample. Arthritis Care Res 2012; 64: 1195–201.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
WORD
Supplementary materials

Levis et al. supplementary material 1
Levis et al. supplementary material

 Word (617 KB)
617 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

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

  • Brooke Levis (a1), Andrea Benedetti (a2), Kira E. Riehm (a3), Nazanin Saadat (a3), Alexander W. Levis (a1), Marleine Azar (a1), Danielle B. Rice (a4), Matthew J. Chiovitti (a3), Tatiana A. Sanchez (a3), Pim Cuijpers (a5), Simon Gilbody (a6), John P. A. Ioannidis (a7), Lorie A. Kloda (a8), Dean McMillan (a6), Scott B. Patten (a9), Ian Shrier (a1), Russell J. Steele (a10), Roy C. Ziegelstein (a11), Dickens H. Akena (a12), Bruce Arroll (a13), Liat Ayalon (a14), Hamid R. Baradaran (a15), Murray Baron (a16), Anna Beraldi (a17), Charles H. Bombardier (a18), Peter Butterworth (a19), Gregory Carter (a20), Marcos H. Chagas (a21), Juliana C. N. Chan (a22), Rushina Cholera (a23), Neerja Chowdhary (a24), Kerrie Clover (a25), Yeates Conwell (a26), Janneke M. de Man-van Ginkel (a27), Jaime Delgadillo (a28), Jesse R. Fann (a29), Felix H. Fischer (a30), Benjamin Fischler (a31), Daniel Fung (a32), Bizu Gelaye (a33), Felicity Goodyear-Smith (a13), Catherine G. Greeno (a34), Brian J. Hall (a35), John Hambridge (a36), Patricia A. Harrison (a37), Ulrich Hegerl (a38), Leanne Hides (a39), Stevan E. Hobfoll (a40), Marie Hudson (a16), Thomas Hyphantis (a41), Masatoshi Inagaki (a42), Khalida Ismail (a43), Nathalie Jetté (a44), Mohammad E. Khamseh (a15), Kim M. Kiely (a45), Femke Lamers (a46), Shen-Ing Liu (a47), Manote Lotrakul (a48), Sonia R. Loureiro (a21), Bernd Löwe (a49), Laura Marsh (a50), Anthony McGuire (a51), Sherina Mohd Sidik (a52), Tiago N. Munhoz (a53), Kumiko Muramatsu (a54), Flávia L. Osório (a55), Vikram Patel (a56), Brian W. Pence (a57), Philippe Persoons (a58), Angelo Picardi (a59), Alasdair G. Rooney (a60), Iná S. Santos (a53), Juwita Shaaban (a61), Abbey Sidebottom (a62), Adam Simning (a26), Lesley Stafford (a63), Sharon Sung (a64), Pei Lin Lynnette Tan (a65), Alyna Turner (a66), Christina M. van der Feltz-Cornelis (a67), Henk C. van Weert (a68), Paul A. Vöhringer (a69), Jennifer White (a70), Mary A. Whooley (a71), Kirsty Winkley (a43), Mitsuhiko Yamada (a72), Yuying Zhang (a73) and Brett D. Thombs (a74)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *