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使用 HADS-D 与 SCID 重性抑郁分类比较的抑郁患病率：一项个体参与者数据荟萃分析。

Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis.

机构信息

Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.

Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.

出版信息

J Psychosom Res. 2020 Dec;139:110256. doi: 10.1016/j.jpsychores.2020.110256. Epub 2020 Sep 23.

DOI:10.1016/j.jpsychores.2020.110256

PMID:33069051

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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%.

CONCLUSIONS

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.

摘要

目的

为了对抑郁状态进行分类并估计疾病的发病率，需要使用经过验证的诊断访谈，但通常会使用筛查工具来替代。我们使用个体参与者数据荟萃分析比较了基于标准的医院焦虑和抑郁量表-抑郁分量表（HADS-D）的截断值≥8 和≥11 与 DSM 结构化临床访谈（SCID）重性抑郁的发病率，并确定替代的 HADS-D 截断值是否可以更准确地估计发病率。

方法

我们通过 Ovid 的 Medline、Medline In-Process 和其他非索引引文、PsycINFO 和 Web of Science（从创建到 2016 年 7 月 11 日）检索了比较 HADS-D 评分与 SCID 重性抑郁状态的研究。估计了 HADS-D 截断值与 SCID 重性抑郁的发病率以及发病率的差异。

结果

共有 41 项研究的 6005 名参与者（689 例 SCID 重性抑郁病例）纳入本研究。HADS-D≥8 的总发病率为 24.5%（95%置信区间（CI）：20.5%，29.0%），HADS-D≥11 的总发病率为 10.7%（95%CI：8.3%，13.8%），SCID 重性抑郁的总发病率为 11.6%（95%CI：9.2%，14.6%）。HADS-D≥11 与 SCID 重性抑郁的发病率最接近，但在新研究中 HADS-D≥11 与 SCID 之间可能存在的差异的 95%预测区间为-21.1%至 19.5%。