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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.

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    16
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    Author
    Wu, Y; Levis, B; Riehm, KE; Saadat, N; Levis, AW; Azar, M; Rice, DB; Boruff, J; Cuijpers, P; Gilbody, S; ...
    Date
    2020
    Source Title
    Psychological Medicine
    Publisher
    Cambridge University Press (CUP)
    University of Melbourne Author/s
    Butterworth, Peter; Turner, Alyna; Stafford, Lesley
    Affiliation
    Psychiatry
    Melbourne School of Psychological Sciences
    Melbourne Institute of Applied Economic and Social Research
    Metadata
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    Document Type
    Journal Article
    Citations
    Wu, Y., Levis, B., Riehm, K. E., Saadat, N., Levis, A. W., Azar, M., Rice, D. B., Boruff, J., Cuijpers, P., Gilbody, S., Ioannidis, J. P. A., Kloda, L. A., McMillan, D., Patten, S. B., Shrier, I., Ziegelstein, R. C., Akena, D. H., Arroll, B., Ayalon, L. ,... Thombs, B. D. (2020). Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.. Psychological Medicine, 50 (8), pp.1-13. https://doi.org/10.1017/S0033291719001314.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/253920
    DOI
    10.1017/S0033291719001314
    Open Access URL
    http://eprints.whiterose.ac.uk/148897/1/PHQ_8_vs_PHQ_9_pre_typesetting_PSM_2019_06_26.docx
    Abstract
    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.

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