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

Brooke Levis, Andrea Benedetti, Kira E Riehm, Nazanin Saadat, Alexander W Levis, Marleine Azar, Danielle B Rice, Matthew J Chiovitti, Tatiana A Sanchez, Pim Cuijpers, Simon Gilbody, John P A Ioannidis, Lorie A Kloda, Dean McMillan, Scott B Patten, Ian Shrier, Russell J Steele, Roy C Ziegelstein, Dickens H Akena, Bruce Arroll & 31 others Liat Ayalon, Hamid R Baradaran, Murray Baron, Anna Beraldi, Charles H Bombardier, Peter Butterworth, Gregory Carter, Marcos H Chagas, Juliana C N Chan, Rushina Cholera, Neerja Chowdhary, Kerrie Clover, Yeates Conwell, Janneke M de Man-van Ginkel, Jaime Delgadillo, Jesse R Fann, Felix H Fischer, Benjamin Fischler, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G Greeno, Brian J Hall, John Hambridge, Patricia A Harrison, Ulrich Hegerl, Leanne Hides, Stevan E Hobfoll, Marie Hudson, Thomas Hyphantis, Picardi Angelo

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)377-385
Number of pages9
JournalBritish Journal of Psychiatry
Volume212
Issue number6
DOIs
Publication statusPublished - Jun 2018

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Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews. / Levis, Brooke; Benedetti, Andrea; Riehm, Kira E; Saadat, Nazanin; Levis, Alexander W; Azar, Marleine; Rice, Danielle B; Chiovitti, Matthew J; Sanchez, Tatiana A; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P A; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Shrier, Ian; Steele, Russell J; Ziegelstein, Roy C; Akena, Dickens H; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid R; Baron, Murray; Beraldi, Anna; Bombardier, Charles H; Butterworth, Peter; Carter, Gregory; Chagas, Marcos H; Chan, Juliana C N; Cholera, Rushina; Chowdhary, Neerja; Clover, Kerrie; Conwell, Yeates; de Man-van Ginkel, Janneke M; Delgadillo, Jaime; Fann, Jesse R; Fischer, Felix H; Fischler, Benjamin; Fung, Daniel; Gelaye, Bizu; Goodyear-Smith, Felicity; Greeno, Catherine G; Hall, Brian J; Hambridge, John; Harrison, Patricia A; Hegerl, Ulrich; Hides, Leanne; Hobfoll, Stevan E; Hudson, Marie; Hyphantis, Thomas; Angelo, Picardi.

In: British Journal of Psychiatry, Vol. 212, No. 6, 06.2018, p. 377-385.

Research output: Contribution to journalArticle

Levis, B, Benedetti, A, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Chiovitti, MJ, Sanchez, TA, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Steele, RJ, Ziegelstein, RC, Akena, DH, Arroll, B, Ayalon, L, Baradaran, HR, Baron, M, Beraldi, A, Bombardier, CH, Butterworth, P, Carter, G, Chagas, MH, Chan, JCN, Cholera, R, Chowdhary, N, Clover, K, Conwell, Y, de Man-van Ginkel, JM, Delgadillo, J, Fann, JR, Fischer, FH, Fischler, B, Fung, D, Gelaye, B, Goodyear-Smith, F, Greeno, CG, Hall, BJ, Hambridge, J, Harrison, PA, Hegerl, U, Hides, L, Hobfoll, SE, Hudson, M, Hyphantis, T & Angelo, P 2018, 'Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews', British Journal of Psychiatry, vol. 212, no. 6, pp. 377-385. https://doi.org/10.1192/bjp.2018.54
Levis, Brooke ; Benedetti, Andrea ; Riehm, Kira E ; Saadat, Nazanin ; Levis, Alexander W ; Azar, Marleine ; Rice, Danielle B ; Chiovitti, Matthew J ; Sanchez, Tatiana A ; Cuijpers, Pim ; Gilbody, Simon ; Ioannidis, John P A ; Kloda, Lorie A ; McMillan, Dean ; Patten, Scott B ; Shrier, Ian ; Steele, Russell J ; Ziegelstein, Roy C ; Akena, Dickens H ; Arroll, Bruce ; Ayalon, Liat ; Baradaran, Hamid R ; Baron, Murray ; Beraldi, Anna ; Bombardier, Charles H ; Butterworth, Peter ; Carter, Gregory ; Chagas, Marcos H ; Chan, Juliana C N ; Cholera, Rushina ; Chowdhary, Neerja ; Clover, Kerrie ; Conwell, Yeates ; de Man-van Ginkel, Janneke M ; Delgadillo, Jaime ; Fann, Jesse R ; Fischer, Felix H ; Fischler, Benjamin ; Fung, Daniel ; Gelaye, Bizu ; Goodyear-Smith, Felicity ; Greeno, Catherine G ; Hall, Brian J ; Hambridge, John ; Harrison, Patricia A ; Hegerl, Ulrich ; Hides, Leanne ; Hobfoll, Stevan E ; Hudson, Marie ; Hyphantis, Thomas ; Angelo, Picardi. / Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews. In: British Journal of Psychiatry. 2018 ; Vol. 212, No. 6. pp. 377-385.
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title = "Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews",
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 Jett{\'e} 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.",
author = "Brooke Levis and Andrea Benedetti and Riehm, {Kira E} and Nazanin Saadat and Levis, {Alexander W} and Marleine Azar and Rice, {Danielle B} and Chiovitti, {Matthew J} and Sanchez, {Tatiana A} and Pim Cuijpers and Simon Gilbody and Ioannidis, {John P A} and Kloda, {Lorie A} and Dean McMillan and Patten, {Scott B} and Ian Shrier and Steele, {Russell J} and Ziegelstein, {Roy C} and Akena, {Dickens H} and Bruce Arroll and Liat Ayalon and Baradaran, {Hamid R} and Murray Baron and Anna Beraldi and Bombardier, {Charles H} and Peter Butterworth and Gregory Carter and Chagas, {Marcos H} and Chan, {Juliana C N} and Rushina Cholera and Neerja Chowdhary and Kerrie Clover and Yeates Conwell and {de Man-van Ginkel}, {Janneke M} and Jaime Delgadillo and Fann, {Jesse R} and Fischer, {Felix H} and Benjamin Fischler and Daniel Fung and Bizu Gelaye and Felicity Goodyear-Smith and Greeno, {Catherine G} and Hall, {Brian J} and John Hambridge and Harrison, {Patricia A} and Ulrich Hegerl and Leanne Hides and Hobfoll, {Stevan E} and Marie Hudson and Thomas Hyphantis and Picardi Angelo",
year = "2018",
month = "6",
doi = "10.1192/bjp.2018.54",
language = "English",
volume = "212",
pages = "377--385",
journal = "British Journal of Psychiatry",
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TY - JOUR

T1 - Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews

AU - Levis, Brooke

AU - Benedetti, Andrea

AU - Riehm, Kira E

AU - Saadat, Nazanin

AU - Levis, Alexander W

AU - Azar, Marleine

AU - Rice, Danielle B

AU - Chiovitti, Matthew J

AU - Sanchez, Tatiana A

AU - Cuijpers, Pim

AU - Gilbody, Simon

AU - Ioannidis, John P A

AU - Kloda, Lorie A

AU - McMillan, Dean

AU - Patten, Scott B

AU - Shrier, Ian

AU - Steele, Russell J

AU - Ziegelstein, Roy C

AU - Akena, Dickens H

AU - Arroll, Bruce

AU - Ayalon, Liat

AU - Baradaran, Hamid R

AU - Baron, Murray

AU - Beraldi, Anna

AU - Bombardier, Charles H

AU - Butterworth, Peter

AU - Carter, Gregory

AU - Chagas, Marcos H

AU - Chan, Juliana C N

AU - Cholera, Rushina

AU - Chowdhary, Neerja

AU - Clover, Kerrie

AU - Conwell, Yeates

AU - de Man-van Ginkel, Janneke M

AU - Delgadillo, Jaime

AU - Fann, Jesse R

AU - Fischer, Felix H

AU - Fischler, Benjamin

AU - Fung, Daniel

AU - Gelaye, Bizu

AU - Goodyear-Smith, Felicity

AU - Greeno, Catherine G

AU - Hall, Brian J

AU - Hambridge, John

AU - Harrison, Patricia A

AU - Hegerl, Ulrich

AU - Hides, Leanne

AU - Hobfoll, Stevan E

AU - Hudson, Marie

AU - Hyphantis, Thomas

AU - Angelo, Picardi

PY - 2018/6

Y1 - 2018/6

N2 - 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.

AB - 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.

U2 - 10.1192/bjp.2018.54

DO - 10.1192/bjp.2018.54

M3 - Article

VL - 212

SP - 377

EP - 385

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

SN - 0007-1250

IS - 6

ER -