@article{ref1,
title="Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis",
journal="Psychological medicine",
year="2020",
author="Wu, Yin and Levis, Brooke and Riehm, Kira E. and Saadat, Nazanin and Levis, Alexander W. and Azar, Marleine and Rice, Danielle B. and Boruff, Jill and Cuijpers, Pim and Gilbody, Simon and Ioannidis, John P. A. and Kloda, Lorie A. and McMillan, Dean and Patten, Scott B. and Shrier, Ian and Ziegelstein, Roy C. and Akena, Dickens H. and Arroll, Bruce and Ayalon, Liat and Baradaran, Hamid R. and Baron, Murray and Bombardier, Charles H. and Butterworth, Peter and Carter, Gregory and Chagas, Marcos H. and Chan, Juliana C. N. and Cholera, Rushina and Conwell, Yeates and de Man-van Ginkel, Janneke M. and Fann, Jesse R. and Fischer, Felix H. and Fung, Daniel and Gelaye, Bizu and Goodyear-Smith, Felicity and Greeno, Catherine G. and Hall, Brian J. and Harrison, Patricia A. and Härter, Martin and Hegerl, Ulrich and Hides, Leanne and Hobfoll, Stevan E. and Hudson, Marie and Hyphantis, Thomas and Inagaki, Masatoshi and Jetté, Nathalie and Khamseh, Mohammad E. and Kiely, Kim M. and Kwan, Yunxin and Lamers, Femke and Liu, Shen-Ing and Lotrakul, Manote and Loureiro, Sonia R. and Lowe, Bernd and McGuire, Anthony and Mohd-Sidik, Sherina and Munhoz, Tiago N. and Muramatsu, Kumiko and Osório, Flavia L. and Patel, Vikram and Pence, Brian W. and Persoons, Philippe and Picardi, Angelo and Reuter, Katrin and Rooney, Alasdair G. and Santos, Iná S. and Shaaban, Juwita and Sidebottom, Abbey and Simning, Adam and Stafford, Lesley and Sung, Sharon and Tan, Pei Lin Lynnette and Turner, Alyna and van Weert, Henk C. and White, Jennifer and Whooley, Mary A. and Winkley, Kirsty and Yamada, Mitsuhiko and Benedetti, Andrea and Thombs, Brett D.",
volume="50",
number="8",
pages="1368-1380",
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.<p /><p>Language: en</p>",
language="en",
issn="0033-2917",
doi="10.1017/S0033291719001314",
url="http://dx.doi.org/10.1017/S0033291719001314"
}