Minimal detectable change of the Patient Health Questionnaire-9, Patient Health Questionnaire-8, and Patient Health Questionnaire-2: individual patient data meta-analysis.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Minimal detectable change of the Patient Health Questionnaire-9, Patient Health Questionnaire-8, and Patient Health Questionnaire-2: individual patient data meta-analysis.
Συγγραφείς:	Wang Y; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada.; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada., Wu Y; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China., González-Domínguez NP; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada., Boruff JT; McGill University Libraries, Montréal, QC, Canada., Levis B; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada., Cuijpers P; Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands., Gilbody S; Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK., Harel D; Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA., Ioannidis JPA; Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA., Markham S; Department of Biostatistics and Health Informatics, King's College London, London, UK., Patten SB; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada., Vigod SN; Women's College Hospital and Research Institute, University of Toronto, Toronto, ON, Canada., Ziegelstein RC; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Benedetti A; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada.; Department of Medicine, McGill University, Montréal, QC, Canada.; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada., Thombs BD; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada brett.thombs@mcgill.ca.; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.; Department of Medicine, McGill University, Montréal, QC, Canada.; Department of Psychiatry, McGill University, Montréal, QC, Canada.
Συλλογικό Έργο:	DEPRESsion Screening Data (DEPRESSD) PHQ Collaboration
Πηγή:	BMJ (Clinical research ed.) [BMJ] 2026 Jul 23; Vol. 394, pp. e100119. Date of Electronic Publication: 2026 Jul 23.
Τύπος έκδοσης:	Journal Article; Meta-Analysis
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: British Medical Association Country of Publication: England NLM ID: 8900488 Publication Model: Electronic Cited Medium: Internet ISSN: 1756-1833 (Electronic) Linking ISSN: 09598138 NLM ISO Abbreviation: BMJ Subsets: MEDLINE
Imprint Name(s):	Original Publication: London : British Medical Association
Ιατρικοί όροι (MeSH):	Major Depressive Disorder/diagnosis , Patient Health Questionnaire/standards , Patient Health Questionnaire*/statistics & numerical data, Humans ; Female ; Adult ; Middle Aged ; Reproducibility of Results ; Psychometrics ; Male
Περίληψη:	Objective: To estimate the minimal detectable change (MDC) for the Patient Health Questionnaire-9 (PHQ-9) and its eight item (PHQ-8) and two item (PHQ-2) versions including differences by participant and study characteristics. Design: Individual participant data meta-analysis. Data Sources: Medline, Medline In-Process and other non-indexed citations, PsycInfo, and Web of Science, 1 January 2000 to 9 May 2018. Eligibility Criteria for Selecting Studies: Datasets from articles in any language if participants were aged ≥18 years, were recruited from any non-psychiatric setting, and were not recruited because they were seeking mental healthcare. Eligible datasets had a classification for major depressive disorder or major depressive episode based on a validated semi-structured or fully structured interview conducted within two weeks of administering the PHQ-9, PHQ-8, or PHQ-2. Results: Pooled MDCs across studies were estimated for the PHQ-9, PHQ-8, and PHQ-2 with random effects meta-analysis for 95% (MDC95), 90% (MDC90), and 67% (MDC67) confidence that change beyond measurement error occurred. PHQ-9, PHQ-8, and PHQ-2 analyses included 42 548 participants (94 studies), 42 592 participants (94 studies), and 44 085 participants (98 studies), respectively. Mean participant age was 49 years (standard deviation 17), and 60% of participants were women. Overall, 10% of participants had major depression (range 1-57% across studies). MDC95 was 5.72 points (95% confidence interval (CI) 5.54 to 5.90, 95% prediction interval (PI) 4.00 to 7.44) for the PHQ-9, 5.51 points (95% CI 5.33 to 5.68, 95% PI 3.87 to 7.15) for the PHQ-8, and 2.26 points (95% CI 2.15 to 2.37, 95% PI 1.20 to 3.32) for the PHQ-2. For the PHQ-9, MDC95 was highest in inpatient healthcare settings at 6.48 (95% CI 6.05 to 6.92) points. MDC95 for the PHQ-9 increased by 0.40 (95% CI 0.25 to 0.55) points for each 10% increase in the proportion of participants with major depression. Sex and age had minimal or no association. Subgroup and meta-regression findings were similar for the PHQ-8 and PHQ-2. Conclusions: Based on the pooled estimate, a six point difference on the PHQ-9, the PHQ version most used in clinical practice, could be an appropriate MDC threshold in general practice. A higher threshold may be preferred in specialty mental healthcare. MDC67 or MDC90 thresholds would provide less certainty that change has occurred. Alternative strategies, such as using the upper end of a prediction interval, would provide more certainty but a greater likelihood of not recognising change. Study Registration: PROSPERO CRD42014010673. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Competing Interests:	Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare no financial relationships with any organisations that might have an interest in the submitted work in the previous three years except: SNV reports royalties from UpToDate for authorship of materials related to depression and pregnancy. CNB declares that he has consulted to Abbvie Canada, Amgen Canada, Bristol Myers Squibb Canada, Celltrion, Eli Lilly Canada, Fresenius Kabi, JAMP Pharmaceuticals, Janssen Canada, Pendopharm Canada, Pfizer Canada, Sandoz Canada, and Takeda Canada. CNB has received grants from Abbvie Canada, Pfizer Canada, and Takeda Canada and also received unrestricted educational grants from Abbvie Canada, Boston Scientific, Bristol Myers Squibb, Eli Lilly, Ferring Canada, Fresenius Kabi, Janssen Canada, Organon Canada, Pfizer Canada, and Takeda Canada, as well as been on speaker’s bureau of Abbvie Canada, Eli Lilly, Fresenius Canada, Janssen Canada, Pfizer Canada, and Takeda Canada, all outside the submitted work. MIn declares that he has received personal fees from Janssen, Viatris, Mochida, Yoshitomi, Otsuka, MSD, Sumitomo, Meiji, Takeda, Eisai, Nippon Kayaku, Kyowa Kirin, Sanwa Kagaku, and Shionogi. MTS declares that the primary study by Janssen et al was supported by unrestricted grants from Janssen, Novo Nordisk, and Sanofi. ER declares that he received grants, personal fees, and non-financial support from Gedeon Richter; personal fees and non-financial support from Lundbeck, Servier, and Janssen Cilag; and personal fees from Zentiva and Abbvie outside the submitted work. KI declares that she has received honorarium for speaker fees for educational lectures for Sanofi, Sunovion, Janssen, and Novo Nordisk. LIW declares that she receives personal fees from Celgene, outside the submitted work. SLP declares that she received salary support from Pfizer-Astella and Millennium, outside the submitted work. JCNC is a steering committee member or consultant, or both, of Astra Zeneca, Bayer, Lilly, MSD, and Pfizer. JCNC has received sponsorships and honorarium for giving lectures and providing consultancy, and her affiliated institution has received research grants from these companies. The contributions of BG were made as part of his official duties as a National Institutes of Health (NIH) federal employee, are in compliance with agency policy requirements, and are considered Works of the US Government. The findings and conclusions presented in this paper are those of the authors and do not necessarily reflect the views of the NIH or US Department of Health and Human Services. All authors declare no other relationships or activities that could appear to have influenced the submitted work.
Contributed Indexing:	Investigator: Y Takwoingi; M Azar; PM Bhandari; MJ Chiovitti; C He; M Imran; LA Kloda; A Krishnan; D Neupane; DB Rice; Y Sun; D Amtmann; B Arrol; L Ayalon; HR Baradaran; CN Bernstein; CH Bombardier; RI Buji; P Butterworth; G Carter; MH Chagas; LF Chan; JCN Chan; D Chibanda; K Clover; A Conway; Y Conwell; FM Daray; JM de Man-van Ginkel; JR Fann; S Field; FH Fischer; JRW Fisher; DSS Fung; B Gelaye; L Gholizadeh; F Goodyear-Smith; EP Green; CG Greeno; BJ Hall; P Hampel; L Hantsoo; EE Haroz; M Härter; U Hegerl; L Hides; SE Hobfoll; T Hyphantis; M Iglesias-González; M Inagaki; K Ismail; HJ Jeon; N Jetté; ME Khamseh; KM Kiely; BA Kohrt; Y Kwan; MA Lara; HF Levin-Aspenson; SI Liu; M Lotrakul; B Löwe; SR Loureiro; NP Luitel; C Lund; RA Marrie; L Marsh; BP Marx; A McGuire; SM Sidik; TN Munhoz; K Muramatsu; JEM Nakku; L Navarrete; FL Osório; BW Pence; I Petersen; A Picardi; SL Pugh; TJ Quinn; E Rancans; SD Rathod; K Reuter; AG Rooney; IS Santos; MT Schram; J Shaaban; EH Shinn; A Sidebottom; L Spangenberg; L Stafford; SC Sung; K Suzuki; RH Swartz; PLL Tan; TD Tran; A Turner; T van Heyningen; CM van der Feltz-Cornelis; LI Wagner; JL Wang; J White; MA Whooley; K Winkley; K Wynter; M Yamada; QZ Zeng; Y Zhang
Entry Date(s):	Date Created: 20260723 Date Completed: 20260723 Latest Revision: 20260723
Update Code:	20260724
DOI:	10.1136/bmj-2026-100119
PMID:	42492960
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1756-1833
DOI:	10.1136/bmj-2026-100119