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

Area of Science:

• Psychiatry
• Clinical Psychology
• Epidemiology

Background:

• Major depression classification in research relies on various diagnostic interviews.
• Semi-structured interviews incorporate clinical judgment, while fully structured interviews are scripted.
• The Mini International Neuropsychiatric Interview (MINI) is a brief, fully structured interview sometimes used in research.

Purpose of the Study:

• To evaluate the association between diagnostic interview method and the odds of major depression classification.
• To control for depressive symptom scores and participant characteristics in the analysis.

Main Methods:

• A meta-analysis of individual participant data from the Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy studies was conducted.
• Binomial generalized linear mixed models were fitted to analyze data from 17,158 participants across 57 primary studies.

Main Results:

• The MINI showed higher odds of major depression classification compared to the Composite International Diagnostic Interview (CIDI) (OR = 2.10).
• Fully structured interviews (excluding MINI) were non-significantly more likely to classify participants with low depressive symptoms (PHQ-9 ≤6) as depressed (OR = 3.13).
• Fully structured interviews (excluding MINI) were significantly less likely to classify participants with high depressive symptoms (PHQ-9 ≥16) as depressed (OR = 0.50).

Conclusions:

• The MINI may lead to a higher identification of depression compared to the CIDI.
• Semi-structured and fully structured interview methods may not be interchangeable for major depression classification.
• Further research is needed to replicate these findings on diagnostic interview methods.