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Title: Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: A systematic review and individual participant data meta-analysis
Authors: Yin Wu
Yin Wu
Yin Wu
Brooke Levis
Kira E. Riehm
Nazanin Saadat
Alexander W. Levis
Marleine Azar
Danielle B. Rice
Danielle B. Rice
Jill Boruff
Pim Cuijpers
Simon Gilbody
John P.A. Ioannidis
Lorie A. Kloda
Dean McMillan
Scott B. Patten
Scott B. Patten
Ian Shrier
Ian Shrier
Roy C. Ziegelstein
Dickens H. Akena
Bruce Arroll
Liat Ayalon
Hamid R. Baradaran
Hamid R. Baradaran
Murray Baron
Murray Baron
Charles H. Bombardier
Peter Butterworth
Peter Butterworth
Gregory Carter
Marcos H. Chagas
Juliana C.N. Chan
Juliana C.N. Chan
Juliana C.N. Chan
Rushina Cholera
Yeates Conwell
Janneke M. De Man-Van Ginkel
Jesse R. Fann
Felix H. Fischer
Daniel Fung
Daniel Fung
Daniel Fung
Daniel Fung
Bizu Gelaye
Felicity Goodyear-Smith
Catherine G. Greeno
Brian J. Hall
Brian J. Hall
Patricia A. Harrison
Martin Härter
Ulrich Hegerl
Leanne Hides
Stevan E. Hobfoll
Marie Hudson
Marie Hudson
Thomas Hyphantis
Masatoshi Inagaki
Nathalie Jetté
Nathalie Jetté
Nathalie Jetté
Mohammad E. Khamseh
Kim M. Kiely
Kim M. Kiely
Yunxin Kwan
Femke Lamers
Shen Ing Liu
Shen Ing Liu
Shen Ing Liu
Shen Ing Liu
Manote Lotrakul
Sonia R. Loureiro
Bernd Löwe
Anthony McGuire
Sherina Mohd-Sidik
Tiago N. Munhoz
Kumiko Muramatsu
Flávia L. Osório
Flávia L. Osório
Vikram Patel
Vikram Patel
Brian W. Pence
Philippe Persoons
Philippe Persoons
Angelo Picardi
Katrin Reuter
Alasdair G. Rooney
Iná S. Santos
Juwita Shaaban
Abbey Sidebottom
Adam Simning
Lesley Stafford
Lesley Stafford
Sharon Sung
Sharon Sung
Pei Lin Lynnette Tan
Alyna Turner
Alyna Turner
Melbourne Institute
Melbourne School of Psychological Sciences
Mackay Medical College
Duke-NUS Medical School Singapore
City of Minneapolis
Hunter Medical Research Institute, Australia
Niigata Seiryo University
Makerere University
Concordia University
University Medical Center Utrecht
Royal Women's Hospital, Carlton
Harvard T.H. Chan School of Public Health
KU Leuven– University Hospital Leuven
The University of Queensland
Mackay Memorial Hospital Taiwan
University of New South Wales (UNSW) Australia
The University of Edinburgh
Yong Loo Lin School of Medicine
Shimane University
Charité – Universitätsmedizin Berlin
Universiti Putra Malaysia
The University of North Carolina at Chapel Hill
KU Leuven
Iran University of Medical Sciences
Universitäts Klinikum Freiburg und Medizinische Fakultät
Prince of Wales Hospital Hong Kong
University of Rochester Medical Center
Neuroscience Research Australia
Universidade de Macau
Lady Davis Institute for Medical Research
UNC School of Medicine
Deakin University
University of Newcastle, Faculty of Health and Medicine
University of York
Saint Joseph's College of Maine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Pittsburgh
University of Washington, Seattle
Universidade Federal de Pelotas
Icahn School of Medicine at Mount Sinai
Stanford University
University of Aberdeen School of Medicine, Medical Sciences and Nutrition
Istituto Superiore Di Sanita
Singapore Institute of Mental Health
The Australian National University
Vrije Universiteit Amsterdam
Universidade de Sao Paulo - USP
Goethe-Universität Frankfurt am Main
University of Auckland
Nanyang Technological University
Johns Hopkins University
Universitätsklinikum Hamburg-Eppendorf und Medizinische Fakultät
Panepistimion Ioanninon
Chinese University of Hong Kong
Bar-Ilan University
Harvard Medical School
School of Medical Sciences - Universiti Sains Malaysia
McGill University
Tan Tock Seng Hospital
University of Calgary
National Institute of Science and Technology
Allina Health
Keywords: Medicine;Psychology
Issue Date: 1-Jun-2020
Citation: Psychological Medicine. Vol.50, No.8 (2020), 1368-1380
Abstract: Copyright © Cambridge University Press 2019. 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.
ISSN: 14698978
Appears in Collections:Scopus 2020

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