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

Levis B 1 , Benedetti A 2 , Riehm KE 3 , Saadat N 3 , Levis AW 1 , Azar M 1 Show all authors , Rice DB 4 , Chiovitti MJ 3 , Sanchez TA 3 , Cuijpers P 5 , Gilbody S 6 , Ioannidis JPA 7 , Kloda LA 8 , McMillan D 6 , Patten SB 9 , Shrier I 1 , Steele RJ 10 , Ziegelstein RC 11 , Akena DH 12 , Arroll B 13 , Ayalon L 14 , Baradaran HR 15 , Baron M 16 , Beraldi A 17 , Bombardier CH 18 , Butterworth P 19 , Carter G 20 , Chagas MH 21 , Chan JCN 22 , Cholera R 23 , Chowdhary N 24 , Clover K 25 , Conwell Y 26 , de Man-van Ginkel JM 27 , Delgadillo J 28 , Fann JR 29 , Fischer FH 30 , Fischler B 31 , Fung D 32 , Gelaye B 33 , Goodyear-Smith F 13 , Greeno CG 34 , Hall BJ 35 , Hambridge J 36 , Harrison PA 37 , Hegerl U 38 , Hides L 39 , Hobfoll SE 40 , Hudson M 16 , Hyphantis T 41 , Inagaki M 42 , Ismail K 43 , Jetté N 44 , Khamseh ME 15 , Kiely KM 45 , Lamers F 46 , Liu SI 47 , Lotrakul M 48 , Loureiro SR 21 , Löwe B 49 , Marsh L 50 , McGuire A 51 , Mohd Sidik S 52 , Munhoz TN 53 , Muramatsu K 54 , Osório FL 55 , Patel V 56 , Pence BW 57 , Persoons P 58 , Picardi A 59 , Rooney AG 60 , Santos IS 53 , Shaaban J 61 , Sidebottom A 62 , Simning A 26 , Stafford L 63 , Sung S 64 , Tan PLL 65 , Turner A 66 , van der Feltz-Cornelis CM 67 , van Weert HC 68 , Vöhringer PA 69 , White J 70 , Whooley MA 71 , Winkley K 43 , Yamada M 72 , Zhang Y 73 , Thombs BD 74

Affiliations 

  • 1 Lady Davis Institute for Medical Research,Jewish General Hospital,Montréal,Québec,CanadaandDepartment of Epidemiology, Biostatistics and Occupational Health,McGill University,Montréal,Québec,Canada
  • 2 Department of Epidemiology, Biostatistics and Occupational Health,McGill University,Montréal,Québec,Canada;Department of Medicine,McGill University,Montréal,Québec,CanadaandRespiratory Epidemiology and Clinical Research Unit,McGill University Health Centre,Montréal,Québec,Canada
  • 3 Lady Davis Institute for Medical Research,Jewish General Hospital,Montréal,Québec,Canada
  • 4 Lady Davis Institute for Medical Research,Jewish General Hospital,Montréal,Québec,CanadaandDepartment of Psychology,McGill University,Montréal,Québec,Canada
  • 5 Department of Clinical, Neuro and Developmental Psychology,EMGO Institute, VU University,Amsterdam,the Netherlands
  • 6 Hull York Medical School and the Department of Health Sciences,University of York,York,UK
  • 7 Department of Medicine,Department of Health Research and Policy,Department of Biomedical Data Science,Department of Statistics,Stanford University,Stanford,California,USA
  • 8 Library,Concordia University,Montréal,Québec,Canada
  • 9 Department of Community Health Sciences,University of Calgary,Calgary,Alberta,Canada and Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary,Calgary,Alberta,Canada
  • 10 Lady Davis Institute for Medical Research,Jewish General Hospital,Montréal,Québec,CanadaandDepartment of Mathematics and Statistics,McGill University,Montréal,Québec,Canada
  • 11 Department of Medicine,Johns Hopkins University School of Medicine,Baltimore,Maryland,USA
  • 12 Department of Psychiatry,Makerere University College of Health Sciences,Kampala,Uganda
  • 13 Department of General Practice and Primary Health Care,University of Auckland,New Zealand
  • 14 Louis and Gabi Weisfeld School of Social Work,Bar Ilan University,Ramat Gan,Israel
  • 15 Endocrine Research Center,Institute of Endocrinology and Metabolism, Iran University of Medical Sciences,Tehran,Iran
  • 16 Lady Davis Institute for Medical Research,Jewish General Hospital,Montréal,Québec,CanadaandDepartment of Medicine,McGill University,Montréal,Québec,Canada
  • 17 Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen,Klinik für Psychiatrie,Psychotherapie & Psychosomatik,Lehrkrankenhaus der Technischen Universität München,Munich,Germany
  • 18 Department of Rehabilitation Medicine,University of Washington,Seattle,Washington,USA
  • 19 Centre for Research on Ageing, Health and Wellbeing,Research School of Population Health,The Australian National University,Canberra,Australia;Centre for Mental Health,Melbourne School of Population and Global Health,University of Melbourne,Melbourne,AustraliaandMelbourne Institute of Applied Economic and Social Research, University of Melbourne,Melbourne,Australia
  • 20 Centre for Translational Neuroscience and Mental Health,University of Newcastle,New South Wales,Australia
  • 21 Department of Neurosciences and Behavior,Ribeirão Preto Medical School,University of São Paulo,Ribeirão Preto,Brazil
  • 22 Department of Medicine and Therapeutics,Prince of Wales Hospital,The Chinese University of Hong Kong,Hong Kong Special Administrative Region,China;Asia Diabetes Foundation,Prince of Wales Hospital,Hong Kong Special Administrative Region,China and Hong Kong Institute of Diabetes and Obesity,Hong Kong Special Administrative Region,China
  • 23 Department of Pediatrics,University of North Carolina at Chapel Hill School of Medicine,Chapel Hill,North Carolina,USA
  • 24 Clinical Psychiatrist, Mumbai,India
  • 25 Centre for Translational Neuroscience and Mental Health,University of Newcastle,New South Wales,AustraliaandPsycho-Oncology Service,Calvary Mater Newcastle,New South Wales,Australia
  • 26 Department of Psychiatry,University of Rochester Medical Center,New York,USA
  • 27 Julius Center for Health Sciences and Primary Care,University Medical Center Utrecht,Utrecht,the Netherlands
  • 28 Clinical Psychology Unit,Department of Psychology,University of Sheffield,Sheffield,UK
  • 29 Department of Psychiatry and Behavioral Sciences,University of Washington,Seattle,Washington,USA
  • 30 Institute for Social Medicine, Epidemiology, and Health Economics,Charité - Universitätsmedizin Berlin,GermanyandDepartment of Psychosomatic Medicine,Center for Internal Medicine and Dermatology,Charité - Universitätsmedizin Berlin,Germany
  • 31 Private Practice,Brussels,Belgium
  • 32 Department of Child & Adolescent Psychiatry,Institute of Mental Health,Singapore;Yong Loo Lin School of Medicine,National University of Singapore,Singapore;Lee Kong Chian School of Medicine,Nanyang Technological University,SingaporeandOffice of Clinical Sciences,Duke-NUS Medical School,Singapore
  • 33 Department of Epidemiology,Harvard T. H. Chan School of Public Health,Boston,Massachusetts,USA
  • 34 School of Social Work,University of Pittsburgh,Pittsburgh,Pennsylvania,USA
  • 35 Global and Community Mental Health Research Group,Department of Psychology,Faculty of Social Sciences,University of Macau,Macau Special Administrative Region,ChinaandDepartment of Health, Behavior, and Society,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
  • 36 Liaison Psychiatry Department,John Hunter Hospital,Newcastle,Australia
  • 37 City of Minneapolis Health Department,Minneapolis,Minnesota,USA
  • 38 Department of Psychiatry and Psychotherapy,University Hospital Leipzig,Leipzig,Germany
  • 39 Centre for Children's Health Research,Institute of Health & Biomedical Innovation,School of Psychology,University of Queensland,Brisbane,Queensland,Australia
  • 40 Department of Behavioral Sciences,Rush University Medical Center,Chicago,Illinois,USA
  • 41 Department of Psychiatry,University of Ioannina,Ioannina,Greece
  • 42 Department of Neuropsychiatry,Okayama University Hospital,Okayama,Japan
  • 43 Department of Psychological Medicine,Institute of Psychiatry, Psychology and Neurosciences,King's College London Weston Education Centre,London,UK
  • 44 Department of Community Health Sciences,University of Calgary,Calgary,Alberta,Canada;Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary,Calgary,Alberta,CanadaandDepartment of Clinical Neurosciences,University of Calgary,Calgary,Alberta,Canada
  • 45 Centre for Research on Ageing, Health and Wellbeing,Research School of Population Health,The Australian National University,Canberra,Australia
  • 46 Department of Psychiatry,Amsterdam Public Health Research Institute, VU University Medical Center,Amsterdam,the Netherlands
  • 47 Office of Clinical Sciences,Duke-NUS Medical School,Singapore;Department of Psychiatry,Mackay Memorial Hospital,Taipei,Taiwan;Department of Medical Research,Mackay Memorial Hospital,Taipei,TaiwanandDepartment of Medicine,Mackay Medical College,Taipei,Taiwan
  • 48 Department of Psychiatry,Faculty of Medicine,Ramathibodi Hospital,Mahidol University,Bangkok,Thailand
  • 49 Department of Psychosomatic Medicine and Psychotherapy,University Medical Center Hamburg-Eppendorf,Hamburg,GermanyandSchön Klinik Hamburg Eilbek,Hamburg,Germany
  • 50 Baylor College of Medicine,HoustonandMichael E. DeBakey Veterans Affairs Medical Center,Houston,Texas,USA
  • 51 Department of Nursing,St. Joseph's College,Standish,Maine,USA
  • 52 Cancer Resource & Education Centre, and Department of Psychiatry,Faculty of Medicine and Health Sciences,Universiti Putra Malaysia,Serdang,Selangor,Malaysia
  • 53 Post-graduate Program in Epidemiology,Federal University of Pelotas,Pelotas,RS,Brazil
  • 54 Department of Clinical Psychology,Graduate School of Niigata Seiryo University,Niigata,Japan
  • 55 Department of Neurosciences and Behavior,Ribeirão Preto Medical School,University of São Paulo,Ribeirão Preto,Brazil and National Institute of Science and Technology,Translational Medicine,Ribeirão Preto,Brazil
  • 56 Department of Global Health and Social Medicine,Harvard Medical School,Boston,Massachusetts,USA;London School of Hygiene & Tropical Medicine,London,UKandCentre for Chronic Conditions and Injuries,Public Health Foundation of India,New Delhi,India
  • 57 Department of Epidemiology,Gillings School of Global Public Health,The University of North Carolina at Chapel Hill,Chapel Hill,North Carolina,USA
  • 58 Department of Adult Psychiatry,University Hospitals Leuven,Leuven,BelgiumandDepartment of Neurosciences,Katholieke Universiteit Leuven,Leuven,Belgium
  • 59 Centre for Behavioural Sciences and Mental Health,Italian National Institute of Health,Rome,Italy
  • 60 Division of Psychiatry,Royal Edinburgh Hospital,University of Edinburg,Edinburgh,Scotland,UK
  • 61 Department of Family Medicine,School of Medical Sciences,Universiti Sains Malaysia,Kelantan,Malaysia
  • 62 Allina Health,Minneapolis,Minnesota,USA
  • 63 Centre for Women's Mental Health,Royal Women's Hospital,Parkville,AustraliaandMelbourne School of Psychological Sciences,University of Melbourne,Australia
  • 64 Department of Child & Adolescent Psychiatry,Institute of Mental Health,SingaporeandOffice of Clinical Sciences,Duke-NUS Medical School,Singapore
  • 65 Department of Psychological Medicine,Tan Tock Seng Hospital,Singapore
  • 66 School of Medicine and Public Health,University of Newcastle,New South Wales,Newcastle,AustraliaandIMPACT Strategic Research Centre,School of Medicine,Deakin University,Geelong,Victoria,Australia
  • 67 Clinical Center of Excellence for Body, Mind and Health,GGz Breburg,Tilburg,the Netherlands and Tilburg University,Faculty of Social Sciences,Tranzo Department,Tilburg,the Netherlands
  • 68 Department of General Practice,Academic Medical Centre Amsterdam,University of Amsterdam,Amsterdam,the Netherlands
  • 69 Department of Psychiatry and Mental Health,Clinical Hospital,Universidad de Chile,Santiago,Chile;Millennium Institute for Depression and Personality Research (MIDAP),Ministry of Economy,Macul,Santiago,ChileandMood Disorders Program,Tufts Medical Center,Tufts University,Boston,USA
  • 70 Monash University,Melbourne,Australia
  • 71 Department of Epidemiology and Biostatistics,University of California San Francisco,San Francisco,California,USA;Department of Medicine,Veterans Affairs Medical Center,San Francisco,California,USAandDepartment of Medicine,University of California San Francisco,San Francisco,California,USA
  • 72 Department of Neuropsychopharmacology,National Institute of Mental Health,National Center of Neurology and Psychiatry,Ogawa-Higashi,Kodaira,Tokyo,Japan
  • 73 Department of Medicine and Therapeutics,Prince of Wales Hospital,The Chinese University of Hong Kong,Hong Kong Special Administrative Region,ChinaandAsia Diabetes Foundation,Prince of Wales Hospital,Hong Kong Special Administrative Region,China
  • 74 Lady Davis Institute for Medical Research,Jewish General Hospital,Montréal,Québec,CanadaandDepartment of Epidemiology, Biostatistics and Occupational Health,Department of Medicine,Department of Psychology,Department of Psychiatry, andDepartment of Educational and Counselling Psychology,McGill University,Montréal, Québec,Canada
Br J Psychiatry, 2018 06;212(6):377-385.
PMID: 29717691 DOI: 10.1192/bjp.2018.54

Abstract

BACKGROUND: Different 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.

METHOD: Data 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.

RESULTS: A 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).

CONCLUSIONS: The 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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