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Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis – ERRATUM
- Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Yeates Conwell, Janneke M. de Manvan Ginkel, Jesse R. Fann, Felix H. Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, Patricia A. Harrison, Martin Härter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Yunxin Kwan, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Anthony McGuire, Sherina Mohd-Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Henk C. van Weert, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Andrea Benedetti, Brett D. Thombs
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- Journal:
- Psychological Medicine / Volume 50 / Issue 16 / December 2020
- Published online by Cambridge University Press:
- 19 August 2019, p. 2816
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Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis
- Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Yeates Conwell, Janneke M. de Man-van Ginkel, Jesse R. Fann, Felix H. Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, Patricia A. Harrison, Martin Härter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Yunxin Kwan, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Anthony McGuire, Sherina Mohd-Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Henk C. van Weert, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Andrea Benedetti, Brett D. Thombs
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- Journal:
- Psychological Medicine / Volume 50 / Issue 8 / June 2020
- Published online by Cambridge University Press:
- 12 July 2019, pp. 1368-1380
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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.
MethodsWe conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results16 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).
ConclusionsPHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews
- Brooke Levis, Andrea Benedetti, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Matthew J. Chiovitti, Tatiana A. Sanchez, Pim Cuijpers, Simon Gilbody, John P. A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Russell J. Steele, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Anna Beraldi, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Neerja Chowdhary, Kerrie Clover, Yeates Conwell, Janneke M. de Man-van Ginkel, Jaime Delgadillo, Jesse R. Fann, Felix H. Fischer, Benjamin Fischler, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, John Hambridge, Patricia A. Harrison, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Khalida Ismail, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Laura Marsh, Anthony McGuire, Sherina Mohd Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Christina M. van der Feltz-Cornelis, Henk C. van Weert, Paul A. Vöhringer, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Yuying Zhang, Brett D. Thombs
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- Journal:
- The British Journal of Psychiatry / Volume 212 / Issue 6 / June 2018
- Published online by Cambridge University Press:
- 02 May 2018, pp. 377-385
- Print publication:
- June 2018
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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.
MethodData 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.
ResultsA 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).
ConclusionsThe 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.
Contributors
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- By Krista Adamek, Ana Luisa K. Albernaz, J. Marcio Ayres†, Andrew J. Baker, Karen L. Bales, Adrian A. Barnett, Christopher Barton, John M. Bates, Jennie Becker, Bruna M. Bezerra, Júlio César Bicca-Marques, Richard Bodmer, Jean P. Boubli, Mark Bowler, Sarah A. Boyle, Christini Barbosa Caselli, Janice Chism, Elena P. Cunningham, José Maria C. da Silva, Lesa C. Davies, Nayara de Alcântara Cardoso, Manuella A. de Souza, Stella de la Torre, Ana Gabriela de Luna, Thomas R. Defler, Anthony Di Fiore, Eduardo Fernandez-Duque, Stephen F. Ferrari, Wilsea M.B. Figueiredo-Ready, Tracy Frampton, Paul A. Garber, Brian W. Grafton, L. Tremaine Gregory, Maria L. Harada, Amy Harrison-Levine, Walter C. Hartwig, Stefanie Heiduck, Eckhard W. Heymann, André Hirsch, Leandro Jerusalinsky, Gareth Jones, Richard F. Kay, Martin M. Kowalewski, Shawn M. Lehman, Laura Marsh, Jesús Martinez, William A. Mason, Hope Matthews, Wynlyn McBride, Shona McCann-Wood, W. Scott McGraw, D. Jeffrey Meldrum, Sally P. Mendoza, Nohelia Mercado, Russell A. Mittermeier, Mirjam N. Nadjafzadeh, Marilyn A. Norconk, Robert Gary Norman, Marcela Oliveira, Marcelo M. Oliveira, Maria Juliana Ospina Rodríguez, Erwin Palacios, Suzanne Palminteri, Liliam P. Pinto, Marcio Port-Carvalho, Leila Porter, Carlos Portillo-Quintero, George Powell, Ghillean T. Prance, Rodrigo C. Printes, Pablo Puertas, P. Kirsten Pullen, Helder L. Queiroz, Luis Reginaldo R. Rodrigues, Adriana Rodríguez, Alfred L. Rosenberger, Anthony B. Rylands, Ricardo R. Santos, Horacio Schneider, Eleonore Z.F. Setz, Suleima S.B. Silva, José S. Silva Júnior, Andrew T. Smith, Marcelo C. Sousa, Antonio S. Souto, Wilson R. Spironello, Masanaru Takai, Marcelo F. Tejedor, Cynthia L. Thompson, Diego G. Tirira, Raul Tupayachi, Bernardo Urbani, Liza M. Veiga, Marianela Velilla, João Valsecchi, Jean-Christophe Vié, Tatiana M. Vieira, Suzanne E. Walker-Pacheco, Rob Wallace, Patricia C. Wright, Charles E. Zartman
- Edited by Liza M. Veiga, Universidade Federal do Pará, Brazil, Adrian A. Barnett, Roehampton University, London, Stephen F. Ferrari, Universidade Federal de Sergipe, Brazil, Marilyn A. Norconk, Kent State University, Ohio
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- Book:
- Evolutionary Biology and Conservation of Titis, Sakis and Uacaris
- Published online:
- 05 April 2013
- Print publication:
- 11 April 2013, pp xii-xv
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Red algal cellular biomass lowers circulating cholesterol concentrations in Syrian golden hamsters consuming hypercholesterolaemic diets
- Scott V. Harding, Hai Lin Zhao, Christopher P. F. Marinangeli, Anthony G. Day, Harrison F. Dillon, Deepak Jain, Peter J. H. Jones
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- Journal:
- British Journal of Nutrition / Volume 102 / Issue 6 / 28 September 2009
- Published online by Cambridge University Press:
- 16 June 2009, pp. 842-847
- Print publication:
- 28 September 2009
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Preliminary evidence suggests that consumption of Porphyridium cruentum (PC) biomass results in hypocholesterolaemic effects; however, mechanisms responsible have not been elucidated. The aim of the present study was to determine whether PC biomass lowers circulating cholesterol concentrations, dose dependently, in hamsters fed hypercholesterolaemic diets for 28 d and determine whether cholesterol biosynthesis is affected. Biomass added to diets at 2·5, 5 and 10 % resulted in 14, 38 and 53 % reductions (P < 0·001) in total plasma cholesterol, respectively, compared with a control diet. Similarly, non-HDL-cholesterol concentrations in the 5 and 10 % PC groups were reduced (P < 0·001) 28 and 45 %, respectively, v. controls. These effects were unrelated to cholesterol fractional synthesis rate (FSR), as this did not differ between either treatment or control animals. PC consumption had no effect on food intake, plasma glucose concentrations or energy expenditure, but percentage of body fat was lower (P < 0·001) in the 5 and 10 % PC groups compared with controls. These data show that PC reduces total plasma cholesterol and non-HDL-cholesterol when incorporated into the diet at levels as low as 2·5 %. The mechanism of action for this reduction may be related to increased excretion since food intakes and cholesterol FSR were not reduced in the animals receiving the PC. In conclusion, the use of PC biomass reduces circulating cholesterol, dose dependently, in hypercholesterolaemic hamsters but not via reductions in cholesterol FSR. There is potential for the use of this biomass as a functional ingredient to aid in the management of blood cholesterol concentrations.
Mechanisms for Interstitial-Mediated Transient Enhanced Diffusion of N-type Dopants
- Scott Anthony Harrison, Thomas F. Edgar, Gyeong S. Hwang
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- Journal:
- MRS Online Proceedings Library Archive / Volume 912 / 2006
- Published online by Cambridge University Press:
- 01 February 2011, 0912-C02-10
- Print publication:
- 2006
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As silicon transistor dimensions scale down, transient enhanced diffusion of n-type dopants has become a major barrier toward achieving required junction depths for transistors. In this paper, we use density functional calculations to identify a pathway by which silicon interstitials can mediate As and P diffusion. We show that As-silicon interstitial and P-silicon interstitial pairs in the neutral and negative charge states diffuse via a mechanism in which the dopant is bond-centered at energy minima and threefold coordinated at the high energy saddle point during dopant migration. For both As-silicon interstitial and P-silicon interstitial pairs, we conclude that the neutral pairs will dominate under intrinsic conditions while the neutral and negatively charged pairs will both contribute under heavily doped extrinsic conditions.
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