Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries: Findings from the ESTSS ADJUST study

Kazlauskas, Evaldas; Geležėlytė, Odeta; Kvedaraitė, Monika; Ajduković, Dean; Johannesson, Kerstin Bergh; Böttche, Maria; Bondjers, Kristina; Dragan, Małgorzata; Figueiredo-Braga, Margarida; Grajewski, Piotr; Anastassiou‐Hadjicharalambous, Xenia; Javakhishvili, Jana Darejan; Lioupi, Chrysanthi; Lueger‐Schuster, Brigitte; Mouthaan, Joanne; Bagarić, Ines Rezo; Sales, Luísa; Schäfer, Ingo; Soydas, Suzan; Tsiskarishvili, Lela; Novaković, Irina Zrnić; Lotzin, Annett

doi:10.1016/j.jad.2023.05.007

Cited by 16 publications

(15 citation statements)

References 23 publications

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“…The results provide a new analytical framework to conceptualize and interpret the PHQ-4 in the context of a Latin American country such as Paraguay. Initially, the proposed unidimensional structure of the PHQ-4 seemed divergent from the original model and supported by different studies, and was composed of two factors: depression and anxiety (Christodoulaki et al, 2022 ; Kazlauskas et al, 2023 ; Khubchandani et al, 2016 ; Kim et al, 2021 ; Kocalevent et al, 2014 ; Kroenke et al, 2009 ; Lenz & Li, 2022 ; Lopez Guerra et al, 2022 ; Löwe et al, 2010 ; Mendoza et al, 2022 ; Mills et al, 2015 ). However, since its construction, PHQ-4 assumes that symptoms of depression and anxiety coexist (Kroenke et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the psychometric evidence of the PHQ-4 since its original development (Kroenke et al, 2009 ), the presence of two factors (anxiety and depression) and adequate reliability have been suggested. The two-factor structure, adequate reliability, and evidence of measurement invariance across different ages, genders, and other groups have been replicated in different countries and population groups (Christodoulaki et al, 2022 ; Kazlauskas et al, 2023 ; Khubchandani et al, 2016 ; Kim et al, 2021 ; Kocalevent et al, 2014 ; Lenz & Li, 2022 ; Lopez Guerra et al, 2022 ; Löwe et al, 2010 ; Mendoza et al, 2022 ; Mills et al, 2015 ).…”

Section: Introductionmentioning

confidence: 94%

“…Regarding the measurement invariance of the PHQ-4, previous studies have shown that the fit indices of the two-dimensional model are consistent despite greater model constraints. Specifically, all previous studies demonstrated that the configural (unrestricted) model presented good fit indices, and that the metric (with restriction of factor loadings between groups) and scalar (with restriction of item intersections between groups) invariance models when comparing male and female groups presented ΔCFI lower than 0.01 and a ΔRMSEA lower than 0.15 (Cano-Vindel et al, 2018 ; Christodoulaki et al, 2022 ; Kazlauskas et al, 2023 ; Kocalevent et al, 2014 ; Mendoza et al, 2022 ). Likewise, a multigroup analysis of the unidimensional model of the PHQ-4 indicated that scalar invariance between male and female groups can also be assumed (Lenz & Li, 2022 ).…”

Section: Introductionmentioning

confidence: 96%

“…The PHQ-4 has been translated into different languages including German (Löwe et al, 2010 ; Wicke et al, 2022 ), Greek (Christodoulaki et al, 2022 ), Korean (Kim et al, 2021 ), Swahili (Materu et al, 2020 ), Arabic (Kliem et al, 2016 ), Persian (Ahmadi et al, 2019 ), Austrian, Croatian, Lithuanian, Portuguese, Swedish (Kazlauskas et al, 2023 ), and Spanish (Kocalevent et al, 2014 ; López Guerra et al, 2022 ). Regarding the psychometric evidence of the PHQ-4 since its original development (Kroenke et al, 2009 ), the presence of two factors (anxiety and depression) and adequate reliability have been suggested.…”

Section: Introductionmentioning

confidence: 99%

“…The reliability estimate of the two-dimensional model, using Cronbach's alpha coefficient, ranged from 0.75 to 0.87, and with the omega coefficient ranged from 0.83 to 0.92 in different cultural contexts (Christodoulaki et al, 2022 ; Kazlauskas et al, 2023 ; Khubchandani et al, 2016 ; Kim et al, 2021 ; Kocalevent et al, 2014 ; Lopez Guerra et al, 2022 ; Löwe et al, 2010 ; Mendoza et al, 2022 ; Mills et al, 2015 ). Similarly, the unidimensional model of the PHQ-4 presented values of Cronbach's alpha and Omega coefficient that varied between 0.82 and 0.91 among different sexes, ages, ethnicities, and other groups (Lenz & Li, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

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Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

Caycho-Rodríguez,

Travezaño-Cabrera,

Torales

et al. 2024

Psicol. Refl. Crít.

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Background Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings. Objective This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics. Methods A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women. Results The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups. Conclusion The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

Caycho-Rodríguez,

Travezaño-Cabrera,

Torales

et al. 2024

Psicol. Refl. Crít.

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Fatigue nach einer COVID-19-Erkrankung im Zusammenhang mit Depressivität und Ängstlichkeit bei Versicherten aus Gesundheits- und Sozialberufen

Mertens,

Nienhaus,

Peters

et al. 2024

Bundesgesundheitsbl

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Zusammenfassung Hintergrund Fatigue bezeichnet einen andauernden Erschöpfungszustand, der auf eine Infektionskrankheit folgen kann. Sie zählt zu den häufigsten Symptomen beim Post-Covid-Syndrom (PCS). Auch bei psychischen Erkrankungen kann Fatigue auftreten, allerdings ist Fatigue, wie andere chronische Erkrankungen, auch selbst ein Risikofaktor für Depressivität und Ängstlichkeit. Ziel der Analyse ist es, zu untersuchen, inwieweit sich Fatigue und Depressivität/Ängstlichkeit gegenseitig bedingen und ob es Unterschiede zwischen PCS-Betroffenen und vollständig Genesenen gibt. Methodik In einer Längsschnittuntersuchung mit 3 Messzeitpunkten wurden Versicherte der Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege, die im Jahr 2020 mit SARS-CoV‑2 infiziert waren, zu Fatigue, Depressivität/Ängstlichkeit und lang anhaltenden COVID-19-Symptomen befragt. Zur Analyse der längsschnittlichen Effekte der beiden Variablen wurde ein kreuzlagiges Paneldatenmodell angewandt. Ergebnisse Die Stichprobe (n = 860) weist zu den 3 Messzeitpunkten einen Anteil von 68,7–75,1 % an PCS-Betroffenen auf. Das Modell zeigt eine Güte von R2 = 61,49 % und durchgehend signifikante Effekte, jedoch unterscheiden sich die kreuzlagigen Pfade nicht signifikant voneinander. Wird danach stratifiziert, ob eine PCS-Symptomatik vorliegt, schwächen sich in beiden Gruppen die kreuzlagigen Effekte ab, während nur in der Gruppe der PCS-Betroffenen die Effekte von Fatigue auf Depressivität und Ängstlichkeit bestehen bleiben. Diskussion Die vorliegenden Ergebnisse zeigen einen wechselseitigen Zusammenhang von Fatigue- und Depressivitäts‑/Ängstlichkeitssymptomatik. PCS-Betroffene könnten von psychotherapeutischen Behandlungen aufgrund ihrer Fatigue profitieren, da dem Entstehen von Depressionen oder Angststörungen vorgebeugt werden kann.

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Dimensionality and reliability of the online version of the Patient Health Questionnaire-4 (PHQ-4) in a large Colombian sample: Results from the PSY-COVID study

Sanabria-Mazo,

Gómez-Acosta,

Castro-Muñoz

et al. 2023

Curr Psychol

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The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief screening instrument to measure depressive and anxiety symptoms. This study evaluated the dimensionality and reliability of the online version of the PHQ-4 in a large sample of the general population in Colombia. Data were collected during the first phase of lockdown measures occasioned by the COVID-19 pandemic. A total of 18,061 adult participants completed the online version of the PHQ-4. The characteristics of the items and subscales were explored. Dimensionality was examined using confirmatory factor analysis (CFA), including an examination of invariance (configural, metric, and scalar) across socio-demographic characteristics. Reliability indices were computed and known-groups validity was addressed by estimating associations between PHQ-4 scores and socio-demographic characteristics. The CFA showed significantly adequate fit indices for the expected two-factor structure, being invariant across gender, age, income level, education level, and region. Internal consistency was satisfactory for the PHQ-2 (α = .83), the GAD-2 (α = .79), and the PHQ-4 (α = .86). Higher scores on depressive (PHQ-2), anxiety (GAD-2), and psychological distress (PHQ-4) symptoms in females and young people, and those respondents with lower income, unemployed, and lower level of education were observed. The findings indicate that the PHQ-4 is a reliable scale for depressive and anxiety symptoms among adult Colombian people, being recommendable this tool for online surveys.

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Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries: Findings from the ESTSS ADJUST study

Cited by 16 publications

References 23 publications

Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

Fatigue nach einer COVID-19-Erkrankung im Zusammenhang mit Depressivität und Ängstlichkeit bei Versicherten aus Gesundheits- und Sozialberufen

Dimensionality and reliability of the online version of the Patient Health Questionnaire-4 (PHQ-4) in a large Colombian sample: Results from the PSY-COVID study

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