Table 3.
HAD-D, PHQ-9, and BDI-II depression severity measures: discriminatory performance of detecting at least moderate depression severity relative to HRSD-17
| % Sensitivity | % Specificity | %PPVa | %NPVb | LR+vec | LR-ved | |
|---|---|---|---|---|---|---|
| (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |
| Moderate severity (defined by scales' developer) by HRSD-17 ≥14 (moderate) cut-off (APA criteria) | ||||||
| HADS-D ≥11 | 54 (44 to 63) | 89 (84 to 95) | 79 (69 to 89) | 71 (64 to 78) | 4.93 (2.91 to 8.36) | 0.52 (0.42 to 0.65) |
| PHQ-9 ≥10 | 89 (83 to 95) | 70 (62 to 78) | 69 (61 to 77) | 90 (84 to 96) | 2.99 (2.26 to 3.95) | 0.15 (0.09 to 0.28) |
| BDI-II ≥20 | 86 (79 to 93) | 70 (61 to 79) | 71 (62 to 79) | 86 (78 to 93) | 2.87 (2.13 to 3.86) | 0.20 (0.12 to 0.34) |
| Optimal cut-off for moderate severity (derived from ROC curve) by HRSD-17 ≥14 cut-off (APA criteria) | ||||||
| HADS-D ≥9 | 74 (65 to 82) | 76 (69 to 83) | 70 (61 to 79) | 79 (72 to 86) | 3.07 (2.21 to 4.26) | 0.35 (0.25 to 0.49) |
| PHQ-9 ≥12 | 77 (69 to 86) | 79 (72 to 86) | 73 (64 to 82) | 82 (76 to 89) | 3.68 (2.57 to 5.27) | 0.29 (0.20 to 0.43) |
| BDI-II ≥23 | 74 (65 to 83) | 75 (67 to 83) | 72 (63 to 81) | 78 (70 to 85) | 3.02 (2.13 to 4.28) | 0.34 (0.24 to 0.49) |
| Moderate severity (defined by scales' developers) by HRSD-17 ≥19 cut- off (NICE criteria) | ||||||
| HADS-D ≥11 | 71 (59 to 84) | 82 (77 to 88) | 52 (40 to 64) | 91 (87 to 96) | 4.00 (2.79 to 5.73) | 0.35 (0.22 to 0.54) |
| PHQ-9 ≥10 | 98 (94 to 99) | 57 (49 to 64) | 39 (30 to 47) | 99 (97 to 99) | 2.27 (1.90 to 2.71) | 0.04 (0.01 to 0.26) |
| BDI-II ≥20 | 91 (83 to 99) | 55 (47 to 63) | 37 (28 to 46) | 96 (91 to 99) | 2.02 (1.66 to 2.45) | 0.16 (0.06 to 0.41) |
| Optimal cut-off for moderate severity (derived from ROC curve) by HRSD-17 ≥19 cut- off (NICE criteria) | ||||||
| HADS-D ≥10 | 82 (71 to 92) | 75 (69 to 81) | 47 (36 to 58) | 94 (90 to 98) | 3.25 (2.44 to 4.32) | 0.25 (0.14 to 0.45) |
| PHQ-9 ≥15 | 89 (81 to 98) | 83 (78 to 89) | 60 (49 to 71) | 97 (94 to 99) | 5.39 (3.79 to 7.67) | 0.13 (0.06 to 0.29) |
| BDI-II ≥28 | 83 (72 to 94) | 80 (73 to 86) | 54 (43 to 66) | 94 (90 to 98) | 4.05 (2.90 to 5.67) | 0.22 (0.12 to 0.41) |
a
Positive predictive value.
b
Negative predictive value.
c
Likelihood ratio for a positive result.
d
Likelihood ratio for a negative result.
APA = American Psychiatric Association. BDI-II = Beck Depression Inventory, Second Edition. HAD-D = Hospital and Anxiety Depression Scale – Depression Subscale. HRSD-17 = 17-item Hamilton Rating Scale for Depression interview. NICE = National Institute for Health and Clinical Excellence. PHQ-9 = Patient Health Questionnaire 9. ROC = receiver operating characteristics.