Comparison of the Accuracy of the 7-Item HADS Depression Subscale and 14-Item Total HADS for Screening for Major Depression: A Systematic Review and Individual Participant Data Meta-Analysis

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Wu Y., Levis B., Daray F. M., Ioannidis J. P. A., Patten S. B., Cuijpers P., ...Daha Fazla

PSYCHOLOGICAL ASSESSMENT, cilt.35, sa.2, ss.95-114, 2023 (SSCI) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 35 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1037/pas0001181
  • Dergi Adı: PSYCHOLOGICAL ASSESSMENT
  • Derginin Tarandığı İndeksler: Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, PASCAL, Periodicals Index Online, Child Development & Adolescent Studies, CINAHL, EBSCO Education Source, Education Abstracts, Educational research abstracts (ERA), EMBASE, MEDLINE, Psycinfo
  • Sayfa Sayıları: ss.95-114
  • Anahtar Kelimeler: HADS-D, HADS-T, individual participant data meta-analysis, depression screening, diagnostic accuracy, QUALITY-OF-LIFE, INTERNATIONAL DIAGNOSTIC INTERVIEW, PATIENT HEALTH QUESTIONNAIRE-9, HOSPITAL ANXIETY, CANCER-PATIENTS, MENTAL-DISORDERS, PSYCHIATRIC MORBIDITY, PSYCHOLOGICAL DISTRESS, RATING-SCALES, DETECTING DEPRESSION
  • Ankara Üniversitesi Adresli: Evet

Özet

The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of >= 7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and >= 15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred.