Patient health questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J86008

Journal:

Journal of Clinical Epidemiology

Year, Volume, Issue, Page(s):

2020 , 122, , 115-128.e1

Publication Website:

Abstract:

Study compared Patient Health Questionnaire-9 (PHQ-9) depression prevalence (scores ≥10) to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. A total of 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included in the meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. Pooled PHQ-9 ≥10 prevalence was 24.6 percent, pooled SCID major depression prevalence was 12.1 percent, and pooled difference was 11.9 percent. The mean study-level PHQ-9 ≥10 to SCID-based prevalence ratio was 2.5 times. PHQ-9 ≥14 and the PHQ-9 diagnostic algorithm provided prevalence closest to SCID major depression prevalence, but study-level prevalence differed from SCID-based prevalence by an average absolute difference of 4.8 percent for PHQ-9 ≥14 and 5.6 percent for the PHQ-9 diagnostic algorithm. Findings indicate PHQ-9 ≥10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies.

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