Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada.
Department of Psychiatry, McGill University, Montreal, Québec, Canada.
Psychother Psychosom. 2021;90(1):28-40. doi: 10.1159/000509283. Epub 2020 Aug 19.
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.
To compare the odds of the major depression classification based on the SCID, CIDI, and MINI.
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.
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).
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.
三项先前的个体参与者数据荟萃分析(IPDMA)报告称,与 DSM 结构化临床访谈(SCID)相比,替代参考标准,主要是复合国际诊断访谈(CIDI)和迷你国际神经精神病学访谈(MINI),在控制抑郁症状严重程度时,往往会错误分类重度抑郁症。然而,结果存在重要的不精确性。
比较基于 SCID、CIDI 和 MINI 的重度抑郁症分类的可能性。
我们纳入并标准化了三个 IPDMA 数据库的数据。对于每个 IPDMA,我们分别拟合二项广义线性混合模型,以比较重度抑郁症分类的调整后优势比(aOR),控制症状严重程度和参与者特征,以及访谈和症状严重程度之间的相互作用。然后,我们使用 DerSimonian-Laird 随机效应荟萃分析综合结果。
总共纳入了来自 212 项研究的 69405 名参与者(7574 名[11%]患有重度抑郁症)。在控制症状严重程度和参与者特征的情况下,MINI(74 项研究;25749 名参与者)比 SCID(108 项研究;21953 名参与者)更频繁地诊断出重度抑郁症(aOR 1.46;95%置信区间[CI] 1.11-1.92)。CIDI(30 项研究;21703 名参与者)和 SCID 的分类优势总体上没有差异(aOR 1.19;95%CI 0.79-1.75);然而,随着筛查评分的增加,CIDI 的 aOR 增加幅度小于 SCID(交互 aOR 0.64;95%CI 0.52-0.80)。
与 SCID 相比,MINI 更频繁地诊断出重度抑郁症。随着症状水平的升高,CIDI 进行抑郁分类的可能性增加幅度较小。使用诊断访谈对抑郁症进行分类的研究的解释应考虑访谈特征。