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. 2021;90(1):28-40.
doi: 10.1159/000509283. Epub 2020 Aug 19.

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

Collaborators, Affiliations

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

Yin Wu et al. Psychother Psychosom. 2021.

Abstract

Introduction: 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.

Objective: To compare the odds of the major depression classification based on the SCID, CIDI, and MINI.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Classification; Depressive disorders; Diagnostic interviews; Individual participant data meta-analysis; Major depression.

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Conflict of interest statement

Conflict of Interest Statement: All authors have completed the ICJME uniform disclosure form and declare no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years. All authors declare no other relationships or activities that could appear to have influenced the submitted work. 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.

Figures

Figure 1.
Figure 1.
Comparison of major depression classification odds of the Composite International Diagnostic Interview (CIDI) versus the Structured Clinical Interview for DSM (SCID) The figure presents the aOR of major depression classification for the CIDI compared to the SCID for primary studies based on the PHQ-9, EPDS, and HADS-D and pooled estimates at standardized scores of −1, 0, 1, 2 and 3. The standardized scores of −1, 0, 1, 2 and 3 are approximately equal to scores of 0, 5, 10, 16 and 21 on the PHQ-9 (SD = 5.26); 1, 7, 13, 18 and 24 on the EPDS (SD = 5.58); and 1, 5, 9, 13 and 17 on the HADS-D (SD = 4.07). We present standardized scores from −1 to 3, because raw scores corresponding to standardized scores below −1 or above 3 would be negative or beyond the maximum scores of the included screening tools. Abbreviations: EPDS: Edinburgh Postnatal Depression Scale; HADS-D: Depression subscale of Hospital Anxiety and Depression Scale; META: Pooled estimates from the synthesis meta-analysis. PHQ-9: Patient Health Questionnaire-9.
Figure 2.
Figure 2.
Comparison of major depression classification odds of the Mini International Neuropsychiatric Interview (MINI) vs. the SCID considering the interaction between depressive symptom severity and the MINI. The figure presents the aOR of major depression classification for the MINI compared to the SCID for primary studies based on the PHQ-9, EPDS, and HADS-D and pooled estimates at standardized scores of −1, 0, 1, 2 and 3. The standardized scores of −1, 0, 1, 2 and 3 are approximately equal to scores of 0, 5, 10, 16 and 21 on the PHQ-9 (SD = 5.26); 1, 7, 13, 18 and 24 on the EPDS (SD = 5.58); and 1, 5, 9, 13 and 17 on the HADS-D (SD = 4.07). We present standardized scores from −1 to 3, because raw scores corresponding to standardized scores below −1 or above 3 would be negative or beyond the maximum scores of the included screening tools. Abbreviations: EPDS: Edinburgh Postnatal Depression Scale; HADS-D: Depression subscale of Hospital Anxiety and Depression Scale; META: Pooled estimates from the synthesis meta-analysis. PHQ-9: Patient Health Questionnaire-9.

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