{Reference Type}: Journal Article
{Title}: Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis.
{Author}: Brehaut E;Neupane D;Levis B;Wu Y;Sun Y;Krishnan A;He C;Bhandari PM;Negeri Z;Riehm KE;Rice DB;Azar M;Yan XW;Imran M;Chiovitti MJ;Saadat N;Cuijpers P;Ioannidis JPA;Markham S;Patten SB;Ziegelstein RC;Henry M;Ismail Z;Loiselle CG;Mitchell ND;Tonelli M;Boruff JT;Kloda LA;Beraldi A;Braeken APBM;Carter G;Clover K;Conroy RM;Cukor D;da Rocha E Silva CE;De Souza J;Downing MG;Feinstein A;Ferentinos PP;Fischer FH;Flint AJ;Fujimori M;Gallagher P;Goebel S;Jetté N;Julião M;Keller M;Kjærgaard M;Love AW;Löwe B;Martin-Santos R;Michopoulos I;Navines R;O'Rourke SJ;Öztürk A;Pintor L;Ponsford JL;Rooney AG;Sánchez-González R;Schwarzbold ML;Sharpe M;Simard S;Singer S;Stone J;Tung KY;Turner A;Walker J;Walterfang M;White J;Benedetti A;Thombs BD;
{Journal}: J Psychosom Res
{Volume}: 139
{Issue}: 0
{Year}: 12 2020
{Factor}: 4.62
{DOI}: 10.1016/j.jpsychores.2020.110256
{Abstract}: Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale - depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence.
We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated.
6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was -21.1% to 19.5%.
HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview.