Construct validity and internal consistency of the Patient Health Questionnaire-9 (PHQ-9) depression screening measure translated into two Ugandan languages

Miller, Amanda P.; Silva, Cristina Espinosa da; Ziegel, Leo; Mugamba, Stephen; Kyasanku, Emma; Bulamba, Robert M; Wagman, Jennifer A.; Ekström, Anna Mia; Nalugoda, Fred; Kigozi, Grace; Nakigozi, Gertrude; Kagaayi, Joseph; Watya, Stephen; Kigozi, Godfrey

doi:10.1016/j.psycom.2021.100002

Cited by 17 publications

(14 citation statements)

References 51 publications

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“…In this study, a self-report questionnaire comprising the following three sections: (1) socio-demographic questions (age, gender, year of study, parental educational attainment, and (2) Mental Health Literacy Scale (MHLS) developed by O'Connor and Casey (21), and (3) the nine-item Patient Health Questionnaire (PHQ-9) depression scale (27,28) were used. Barriers to care for depression were assessed by 11 items included in Table 3.…”

Section: Methodsmentioning

confidence: 99%

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Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Amone-P’Olak

Kakinda²,

Kibedi³

et al. 2023

Front. Public Health

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BackgroundDepression represents a significant mental health problem (MHP) in low- and middle-income countries (LMICs), especially among early adults. Nevertheless, most early adults with depression do not seek treatment. Failure to recognize depression and knowledge about mental health literacy (MHL) may contribute to poor help-seeking behavior. This study assessed MHL, access and barriers to mental health care for depression among early adults in Uganda.MethodsData were collected from students in two of the largest universities in Uganda. Participants completed questionnaires on depression, MHL, sources of barriers and opportunities for MH service. Regression analyses and parametric tests were used to assess depression, access, barriers and opportunities to promote MH.ResultsAbout 12 per cent (n = 56) of the respondents were at the level of moderately severe to severe depression. Mental health literacy (MHL) scores were generally low ranging from “Ability to recognize mental disorders” (mean = 19.32, SD 3.22, range 18–32), and “Knowledge of risk factors” (mean = 4.39, SD 1.17, range 2–8), and “Knowledge of available information” (mean = 9.59, SD 2.53, range 5–20). Respondents reported barriers such as “stigma/discrimination” (65.53%), “lack of knowledge of where to receive help” (65.15%), “lack of trust in health workers” (62.56%), and “distant health facilities” (19.70%) that impede access to treatment and care. MHL significantly predicted depression (based on a continuous scale) (β = 0.63, 95% confidence interval [CI]: [0.56, 0.70]) with the regression model yielding a significant fit [R2 = 0.40, F (2, 460) = 189.84, p < 0.001].ConclusionsMHL is low among university students amidst several barriers such as stigma, fear, and lack of trust. To attenuate the negative effects of MHPs on wellbeing and lower the increased risk of psychopathology into adulthood, it is critical to prioritize MHL, address barriers to treatment and care, and develop the requisite infrastructure to tackle depression among early adults.

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Section: Methodsmentioning

confidence: 99%

“…A cut-off score of 10 is suggested as indicating a possible diagnosis of depressive disorder. The PHQ-9 has previously been used in Uganda with excellent psychometric properties ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Amone-P’Olak

Kakinda²,

Kibedi³

et al. 2023

Front. Public Health

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“…to understand its effects and design possible interventions [14][15][16][17]. Ugandan clinicians and researchers have employed various psychometrically validated tools to screen and diagnose depression among Ugandans, including the Patient Health Questionnaire (PHQ), Beck's Depression Inventory (BDI), Hamilton Rating Scale for Depression, Symptom Checklist-20, Center for Epidemiologic Studies-Depression Scale, Akena Visual Depression Inventory, and the Mini-International Neuropsychiatric Interview (MINI) [18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of depression in Uganda: A systematic review and meta-analysis

Kaggwa

Najjuka²,

Bongomin³

et al. 2022

PLoS ONE

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Background Depression is one of the most studied mental health disorders, with varying prevalence rates reported across study populations in Uganda. A systematic review and meta-analysis was carried out to determine the pooled prevalence of depression and the prevalence of depression across different study populations in the country. Methods Papers for the review were retrieved from PubMed, Scopus, PsycINFO, African Journal OnLine, and Google Scholar databases. All included papers were observational studies regarding depression prevalence in Uganda, published before September 2021. The Joanna Briggs Institute Checklist for Prevalence Studies was used to evaluate the risk of bias and quality of the included papers, and depression pooled prevalence was determined using a random-effects meta-analysis. Results A total of 127 studies comprising 123,859 individuals were identified. Most studies were conducted among individuals living with HIV (n = 43; 33.9%), and the most frequently used instrument for assessing depression was the Depression sub-section of the Hopkins Symptom Checklist (n = 34). The pooled prevalence of depression was 30.2% (95% confidence interval [CI]: 26.7–34.1, I2 = 99.80, p<0.001). The prevalence of depression was higher during the COVID-19 pandemic than during the pre-pandemic period (48.1% vs. 29.3%, p = 0.021). Refugees had the highest prevalence of depression (67.6%; eight studies), followed by war victims (36.0%; 12 studies), individuals living with HIV (28.2%; 43 studies), postpartum or pregnant mothers (26.9%; seven studies), university students (26.9%; four studies), children and adolescents (23.6%; 10 studies), and caregivers of patients (18.5%; six studies). Limitation Significantly high levels of heterogeneity among the studies included. Conclusion Almost one in three individuals in Uganda has depression, with the refugee population being disproportionately affected. Targeted models for depression screening and management across various populations across the country are recommended. Trial registration Protocol registered with PROSPERO (CRD42022310122).

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“…This is particularly important in relation to social desirability, because it implies that none of the content is affected by this source of systematic variability, when applied as a self-report on workers. This relationship probably increases in an interview where PHQ-9 is included, as has been reported in other contexts and groups of participants ( 80 , 81 ). Less literature exists on this association in PHQ-9 and in Latin American workers, and we cannot reliably make safe generalization.…”

Section: Discussionmentioning

confidence: 57%

Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers

et al. 2023

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BackgroundThis study aimed to examine the internal structure and assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) in a Puerto Rican sample of workers. This instrument is a nine-item questionnaire, which was conceptualized as a unidimensional structure; however, there are mixed results regarding this internal structure. This measure is used in the occupational health psychology context in organizations in Puerto Rico; nevertheless, there is little evidence of its psychometric properties with samples of workers.Materials and methodsA total of 955 samples from two different study samples were used in this cross-sectional study design in which the PHQ-9 was used. We conducted confirmatory factor analysis, bifactor analysis, and random intercept item factor analysis to examine the internal structure of the PHQ-9. Moreover, a two-factor model was examined by randomly assigning items to the two factors. Measurement invariance across sex and the relationship with other constructs were examined.ResultsThe best-fitted model was the bifactor model followed by the random intercept item factor. The five sets of two-factor models with items randomly assigned obtained acceptable and similar fit indices regardless of the items.ConclusionThe results suggest that the PHQ-9 appears to be a reliable and valid instrument to measure depression. The more parsimonious interpretation of its scores, for now, is a unidimensional structure. Comparison across sex appears to be useful in occupational health psychology research settings since the results suggest that the PHQ-9 is invariant regarding this variable.

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Construct validity and internal consistency of the Patient Health Questionnaire-9 (PHQ-9) depression screening measure translated into two Ugandan languages

Cited by 17 publications

References 51 publications

Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Prevalence of depression in Uganda: A systematic review and meta-analysis

Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers

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