scholarly journals Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews

2018 ◽  
Vol 212 (6) ◽  
pp. 377-385 ◽  
Author(s):  
Brooke Levis ◽  
Andrea Benedetti ◽  
Kira E. Riehm ◽  
Nazanin Saadat ◽  
Alexander W. Levis ◽  
...  
Keyword(s):  
Major Depression ◽  
Meta Analysis ◽  
Committee Member ◽  
Composite International Diagnostic Interview ◽  
Structured Interview ◽  
Steering Committee ◽  
Diagnostic Interview ◽  
Structured Interviews ◽  
Interview Method ◽  
Diagnostic Interviews

BackgroundDifferent diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.MethodData collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.ResultsA total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).ConclusionsThe MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

scholarly journals Probability of Major Depression Classification Based on the SCID, CIDI, and MINI Diagnostic Interviews: A Synthesis of Three Individual Participant Data Meta-Analyses

2020 ◽  
Vol 90 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Yin Wu ◽  
Brooke Levis ◽  
John P.A. Ioannidis ◽  
Andrea Benedetti ◽  
Brett D. Thombs ◽  
...  
Keyword(s):  
Major Depression ◽  
Symptom Severity ◽  
Meta Analysis ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Depression Symptom ◽  
Individual Participant Data ◽  
Diagnostic Interviews ◽  
Individual Participant ◽  
Meta Analyses

<b><i>Introduction:</i></b> Three previous individual participant data meta-analyses (IPDMAs) reported that, compared to the Structured Clinical Interview for the DSM (SCID), alternative reference standards, primarily the Composite International Diagnostic Interview (CIDI) and the Mini International Neuropsychiatric Interview (MINI), tended to misclassify major depression status, when controlling for depression symptom severity. However, there was an important lack of precision in the results. <b><i>Objective:</i></b> To compare the odds of the major depression classification based on the SCID, CIDI, and MINI. <b><i>Methods:</i></b> We included and standardized data from 3 IPDMA databases. For each IPDMA, separately, we fitted binomial generalized linear mixed models to compare the adjusted odds ratios (aORs) of major depression classification, controlling for symptom severity and characteristics of participants, and the interaction between interview and symptom severity. Next, we synthesized results using a DerSimonian-Laird random-effects meta-analysis. <b><i>Results:</i></b> In total, 69,405 participants (7,574 [11%] with major depression) from 212 studies were included. Controlling for symptom severity and participant characteristics, the MINI (74 studies; 25,749 participants) classified major depression more often than the SCID (108 studies; 21,953 participants; aOR 1.46; 95% confidence interval [CI] 1.11–1.92]). Classification odds for the CIDI (30 studies; 21,703 participants) and the SCID did not differ overall (aOR 1.19; 95% CI 0.79–1.75); however, as screening scores increased, the aOR increased less for the CIDI than the SCID (interaction aOR 0.64; 95% CI 0.52–0.80). <b><i>Conclusions:</i></b> Compared to the SCID, the MINI classified major depression more often. The odds of the depression classification with the CIDI increased less as symptom levels increased. Interpretation of research that uses diagnostic interviews to classify depression should consider the interview characteristics.

scholarly journals Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

BMJ ◽  
2019 ◽  
pp. l1476 ◽  
Author(s):  
Brooke Levis ◽  
Andrea Benedetti ◽  
Brett D Thombs
Keyword(s):  
Major Depression ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Patient Health Questionnaire ◽  
Individual Participant Data ◽  
Health Questionnaire ◽  
Structured Interviews ◽  
Diagnostic Interviews ◽  
Patient Health ◽  
Individual Participant

Abstract Objective To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. Design Individual participant data meta-analysis. Data sources Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). Inclusion criteria Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. Results Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. Conclusions PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. Registration PROSPERO CRD42014010673.

Case Ascertainment: The Composite International Diagnostic Interview

2000 ◽  
Vol 34 (1_suppl) ◽  
pp. A161-A163 ◽  
Author(s):  
Gavin Andrews
Keyword(s):  
False Positive ◽  
False Negative ◽  
Composite International Diagnostic Interview ◽  
Structured Interview ◽  
Diagnostic Interview ◽  
Current Situation ◽  
Community Surveys ◽  
Case Ascertainment ◽  
Diagnostic Interviews

Objective To outline the utility of the Composite International Diagnostic Interview (CIDI) in the diagnosis of psychosis. Method Report current situation. Results The CIDI was designed as a fully structured interview to be used by lay interviewers. It generates false positive diagnoses in community surveys and false negative diagnoses in psychiatric settings. A new psychosis module has been developed to reduce these problems. Conclusions The diagnosis of psychosis by fully structured diagnostic interviews is difficult.

scholarly journals Accuracy of the Hospital Anxiety and Depression Scale Depression subscale (HADS-D) to screen for major depression: systematic review and individual participant data meta-analysis

BMJ ◽  
2021 ◽  
pp. n972
Author(s):  
Yin Wu ◽  
Brooke Levis ◽  
Ying Sun ◽  
Chen He ◽  
Ankur Krishnan ◽  
...  
Keyword(s):  
Major Depression ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Depression Scale ◽  
Diagnostic Interview ◽  
Anxiety And Depression ◽  
Individual Participant Data ◽  
Structured Interviews ◽  
Depression Subscale ◽  
Individual Participant

AbstractObjectiveTo evaluate the accuracy of the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) to screen for major depression among people with physical health problems.DesignSystematic review and individual participant data meta-analysis.Data sourcesMedline, Medline In-Process and Other Non-Indexed Citations, PsycInfo, and Web of Science (from inception to 25 October 2018).Review methodsEligible datasets included HADS-D scores and major depression status based on a validated diagnostic interview. Primary study data and study level data extracted from primary reports were combined. For HADS-D cut-off thresholds of 5-15, a bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, in studies that used semi-structured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders), fully structured interviews (eg, Composite International Diagnostic Interview), and the Mini International Neuropsychiatric Interview. One stage meta-regression was used to examine whether accuracy was associated with reference standard categories and the characteristics of participants. Sensitivity analyses were done to assess whether including published results from studies that did not provide raw data influenced the results.ResultsIndividual participant data were obtained from 101 of 168 eligible studies (60%; 25 574 participants (72% of eligible participants), 2549 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of seven or higher for semi-structured interviews, fully structured interviews, and the Mini International Neuropsychiatric Interview. Among studies with a semi-structured interview (57 studies, 10 664 participants, 1048 with major depression), sensitivity and specificity were 0.82 (95% confidence interval 0.76 to 0.87) and 0.78 (0.74 to 0.81) for a cut-off value of seven or higher, 0.74 (0.68 to 0.79) and 0.84 (0.81 to 0.87) for a cut-off value of eight or higher, and 0.44 (0.38 to 0.51) and 0.95 (0.93 to 0.96) for a cut-off value of 11 or higher. Accuracy was similar across reference standards and subgroups and when published results from studies that did not contribute data were included.ConclusionsWhen screening for major depression, a HADS-D cut-off value of seven or higher maximised combined sensitivity and specificity. A cut-off value of eight or higher generated similar combined sensitivity and specificity but was less sensitive and more specific. To identify medically ill patients with depression with the HADS-D, lower cut-off values could be used to avoid false negatives and higher cut-off values to reduce false positives and identify people with higher symptom levels.Trial registrationPROSPERO CRD42015016761.

scholarly journals The Moderating Effects of Coping Strategies on Major Depression in the General Population

2002 ◽  
Vol 47 (2) ◽  
pp. 167-173 ◽  
Author(s):  
JianLi Wang ◽  
Scott B Pat ten
Keyword(s):  
Major Depression ◽  
General Population ◽  
Coping Strategies ◽  
Life Stress ◽  
Depressive Disorders ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Moderating Effects

Objectives: To evaluate the moderating effects of various coping strategies on the as sociation between stressors and the prevalence of major depression in the general population. Methods: Subjects from the Alberta buy- incomponent of the 1994 –1995 National Population Health Survey (NPHS) were included in the analysis ( n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI- SF) for major depression. The im pacts of coping strategies in relation to psychological stres sors on the prevalence of major depression were de ter mined by examining interactions between coping and life stress on major depression using logistic regression modelling. Results: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of “pray and seek religious help” and “talks to others about the situations” as coping strategies by women moderated the risk of major depression in the presence of financial stress and relation ship stress (with a partner). Using emotional expression as a coping strategy by women might de crease the risk of major depression in the presence of 1 or more re cent life events, personal stress, relationship stress (with a partner), and environmental stress. Conclusion: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

scholarly journals Comorbid Depression among Untreated Illicit Opiate Users: Results from a Multisite Canadian Study

2005 ◽  
Vol 50 (9) ◽  
pp. 512-518 ◽  
Author(s):  
T Cameron Wild ◽  
Nady el-Guebaly ◽  
Benedickt Fischer ◽  
Suzanne Brissette ◽  
Serge Brochu ◽  
...  
Keyword(s):  
Major Depression ◽  
Drug Use ◽  
Service Use ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Quebec City ◽  
Comorbid Depression ◽  
Chi Square ◽  
Targeted Interventions

Objectives: This study aimed to describe patterns of major depression (MDD) in a cohort of untreated illicit opiate users recruited from 5 Canadian urban centres, identify sociodemographic characteristics of opiate users that predict MDD, and determine whether opiate users suffering from depression exhibit different drug use patterns than do participants without depression. Method: Baseline data were collected from 679 untreated opiate users in Vancouver, Edmonton, Toronto, Montreal, and Quebec City. Using the Composite International Diagnostic Interview Short Form for Major Depression, we assessed sociodemographics, drug use, health status, health service use, and depression. We examined depression rates across study sites; logistic regression analyses predicted MDD from demographic information and city. Chi-square analyses were used to compare injection drug use and cocaine or crack use among participants with and without depression. Results: Almost one-half (49.3%) of the sample met the cut-off score for MDD. Being female, white, and living outside Vancouver independently predicted MDD. Opiate users suffering from depression were more likely than users without depression to share injection equipment and paraphernalia and were also more likely to use cocaine ( Ps < 0.05). Conclusions: Comorbid depression is common among untreated opiate users across Canada; targeted interventions are needed for this population.

scholarly journals The informative and the performative in semi-structured interviews: The example of a study of territorial capital in Serbia

Sociologija ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 83-104
Author(s):  
Ivana Spasic
Keyword(s):  
Qualitative Methodology ◽  
Social Institutions ◽  
Role Playing ◽  
Structured Interview ◽  
Structured Interviews ◽  
Quality Of Data ◽  
Interview Method ◽  
Political Implications ◽  
Different Dimensions

The paper reexamines the semi-structured interview method on the basis of data collected in a study of medium-sized Serbian towns. The analysis of transcripts shows that the analytic quality of data varied depending on the interviewee?s position in the local institutional structure, so that in interviews with representatives of political and social institutions role playing (the performative) prevailed over providing information on social reality and attitudes (the informative). This finding is situated in the context of current debates within qualitative methodology which, while illuminating the complex intertwining of different dimensions of the interview (as source of data and interaction situation), fail to recognize fully the problem of performativity and provide solutions. In the final section some undesired epistemological and political implications are discussed of an uncritical application of the semi-structured interview if conceived in an overly antipositivistic fashion and disregarding the institutional and broader social framework within which the research takes place.

scholarly journals 1497Implementing the TRAPD model for the Saudi adaptation of the Composite International Diagnostic Interview 3.0

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yasmin Altwaijri
Keyword(s):  
Mental Health ◽  
Health Indicators ◽  
Composite International Diagnostic Interview ◽  
Structured Interview ◽  
Specific Model ◽  
Diagnostic Interview ◽  
Saudi Population ◽  
Translation Model ◽  
European Languages ◽  
Health Decision

Abstract Background The World Mental Health-Composite International Diagnostic Interview (CIDI) 3.0, originally in English, is a fully-structured interview designed for the assessment of mental disorders. Although Arabic translations of CIDI from countries like Lebanon and Iraq exist, a Modern Standard Arabic translation was developed to suit the Saudi population. While the translation model used in the present paper has been used to translate instruments in Asian and European languages, there is no study to the best of our knowledge which has used this specific model to translate a validated instrument from English to Arabic. Case presentation This paper describes the Saudi adaptation of CIDI 3.0. The TRAPD team translation model—comprising of translation, review, adjudication, pretesting and documentation—was implemented to carry out the Saudi adaptation of CIDI 3.0. Pretests involving cognitive interviewing and pilot study led to translation revisions which consequently confirmed that Saudi respondents had a good understanding of various items of the instrument. The adaptation procedures for the Saudi CIDI 3.0 were well documented and the instrument was linguistically validated with the Saudi population. Conclusions The TRAPD model was successfully implemented to adapt the CIDI 3.0 to be used as the main survey instrument for the Saudi National Mental Health Survey, findings of which will provide health policy makers mental health indicators for health decision making and planning. Key messages The CIDI 3.0 is a resourceful tool for examining mental health issues in the GCC.

Biopsychosocial correlates of lifetime major depression in a multiple sclerosis population

2000 ◽  
Vol 6 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Scott B Patten ◽  
Luanne M Metz ◽  
Marlene A Reimer
Keyword(s):  
Multiple Sclerosis ◽  
Major Depression ◽  
Depressive Disorders ◽  
Causal Effect ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Cross Sectional ◽  
Multiple Sclerosis Population ◽  
Additional Data Collection

The objective of this paper was to evaluate the lifetime and point prevalence of major depression in a population-based Multiple Sclerosis (MS) clinic sample, and to describe associations between selected biopsychosocial variables and the prevalence of lifetime major depression in this sample. Subjects who had participated in an earlier study were re-contacted for additional data collection. Eighty-three per cent (n=136) of those eligible consented to participate. Each subject completed the Composite International Diagnostic Interview (CIDI) and an interviewer-administered questionnaire evaluating a series of biopsychosocial variables. The lifetime prevalence of major depression in this sample was 22.8%, somewhat lower than previous estimates in MS clinic populations. Women, those under 35, and those with a family history of major depression had a higher prevalence. Also, subject reporting high levels of stress and heavy ingestion of caffeine (>400 mg) had a higher prevalence of major depression. As this was a cross-sectional analysis, the direction of causal effect for the observed associations could not be determined. By identifying variables that are associated with lifetime major depression, these data generate hypotheses for future prospective studies. Such studies will be needed to further understand the etiology of depressive disorders in MS.

scholarly journals Outcome of major depression in Ethiopia

2006 ◽  
Vol 189 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Souci Mogga ◽  
Martin Prince ◽  
Atalay Alem ◽  
Derege Kebede ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Major Depression ◽  
Help Seeking ◽  
Service Use ◽  
Psychological Symptoms ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Residual Symptoms ◽  
Depressed Group ◽  
Persistent Depression

BackgroundThe outcome and impact of major depression in developing countries are not clear.AimsTo describe the outcome of major depression and compare the disability and patterns of service use among different outcome groups.MethodIn a case cohort study, nested within a population-based survey of 68 000 participants using the Composite International Diagnostic Interview (CIDI), 300 participants were randomly selected from those with current major depression and 300 from those with no lifetime history. Participants were re-interviewed after 18–62 months to ascertain current diagnosis, psychological symptoms, disability and use of health services.ResultsOf participants with major depression at baseline 26% also met criteria for major depression at follow up. Mortality ratio standardised for age and gender was 3.55 (95% CI 1.97 to 6.39). All indices of measure of disability were significantly higher in the persistently depressed group compared with the completely recovered group. Participants who had recovered partially resembled participants with persistent depression. Two-thirds of those with persistent depression had not sought any help.ConclusionsMajor depression was associated with mortality and disability Those with residual symptoms remained disabled. Help-seeking was unusual.

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