Publication:
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: A systematic review and individual participant data meta-analysis

Issued Date

2020-06-01

Resource Type

Review

ISSN

14698978
00332917

DOI

10.1017/S0033291719001314

Other identifier(s)

2-s2.0-85069052660

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Psychological Medicine. Vol.50, No.8 (2020), 1368-1380

Suggested Citation

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 Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: A systematic review and individual participant data meta-analysis. Psychological Medicine. Vol.50, No.8 (2020), 1368-1380. doi:10.1017/S0033291719001314 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/58148

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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

Author(s)

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

Other Contributor(s)

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
 STAR-Stress
 National Institute of Science and Technology
 Allina Health

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.

Keyword(s)

Medicine
 Psychology

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/58148

Collections

Scopus 2020