- Title
- Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis
- Creator
- Wu, Yin; Levis, Brooke; Riehm, Kira E.; Saadat, Nazanin; Levis, Alexander W.; Azar, Marleine; Rice, Danielle B.; Boruff, Jill; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P.A.; Kloda, Lorie A.; McMillan, Dean; Patten, Scott B.; Shrier, Ian; Ziegelstein, Roy C.; Akena, Dickens H.; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid R.; Carter, Gregory; Turner, Alyna
- Relation
- Psychological Medicine Vol. 50, Issue 8, p. 1368-1380
- Publisher Link
- http://dx.doi.org/10.1017/S0033291719001314
- Publisher
- Cambridge University Press
- Resource Type
- journal article
- Date
- 2020
- Description
- 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.
- Subject
- depression; diagnostic accuracy; SDG 7; individual participant data meta-analysis; meta-analysis; PHQ-8; PHQ-9; screening; systematic review; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1428962
- Identifier
- uon:38673
- Identifier
- ISSN:0033-2917
- Rights
- This article has been published in a revised form in Psychological Medicine http://dx.doi.org/10.1017/S0033291719001314. This version is free to view and download for private research and study only. Not for re-distribution or re-use. © Cambridge University Press 2019
- Language
- eng
- Full Text
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