The Patient Health Questionnaire-9 among First-Trimester Pregnant Women in Japan: Factor Structure and Measurement and Structural Invariance between Nulliparas and Multiparas and across Perinatal Measurement Time Points

Wakamatsu, Mikiyo; Minatani, Mariko; Hada, Ayako; Kitamura, Toshinori

doi:10.4236/ojd.2021.103008

Cited by 3 publications

(4 citation statements)

References 57 publications

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“…The second factor consists of loss of interest, depressed mood, self-blame, concentration difficulty, psychomotor symptom, and suicidality items. Measurement invariance has been confirmed Wakamatsu et al [ 43 ].…”

Section: Methodsmentioning

confidence: 69%

Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan

Hada

Minatani²,

Wakamatsu

et al. 2022

Healthcare

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Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10–13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ2/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy–Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face.

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Section: Methodsmentioning

confidence: 69%

Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan

Hada

Minatani²,

Wakamatsu

et al. 2022

Healthcare

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“…Two studies involving Peruvian pregnant women agreed on indicating the same two-factor solution with the same items assigned to each scale (Smith et al 2022a , b ; Zhong et al 2014 ). Similarly, a Japanese study found a two-factor model but with different assignments of items to scales (Wakamatsu et al 2021 ). Further two studies involving Ethiopian versus Ivorian and Ghanaian pregnant women suggested a one-factor structure (Barthel et al 2015 ; Woldetensay et al 2018 ).…”

Section: Discussionmentioning

confidence: 95%

Comparing the factor structures and reliabilities of the EPDS and the PHQ-9 for screening antepartum and postpartum depression: a multigroup confirmatory factor analysis

Stefana

Langfus

Palumbo³

et al. 2023

Arch Womens Ment Health

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To evaluate and compare the factor structure and reliability of EPDS and PHQ in antepartum and postpartum samples. Parallel analysis and exploratory factor analysis were conducted to determine the structure of both scales in the entire sample as well as in the antepartum and postpartum groups. McDonald’s omega statistics examined the utility of treating items as a single scale versus multiple factors. Multigroup confirmatory factor analysis (MCFA) was utilized to test the measurement invariance between the antepartum and postpartum groups. Two-factor models fit best for the EPDS in both the antepartum and postpartum groups; however, the most reliable score variance was attributable to a general factor for each scale. MCFA provided evidence of weak invariance across groups regarding factor loadings and partial invariance regarding item thresholds. PHQ-9 showed a two-factor model in the antepartum group; however, the same model did not fit well in the postpartum group. EPDS should be preferred to PHQ-9 for measuring depressive symptoms in peripartum populations. Both scales should be used as a single-factor scale. Caution is required when comparing the antepartum and postpartum scores.

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“…This was a secondary analysis of our previously reported epidemiological dataset [26][27][28][29]. Approximately 1500 pregnant women in the period of 10 to 13 weeks' gestational age were recruited at the antenatal clinic of one general hospital and five private clinics located in Tokyo, Chiba, Ibaraki, and Kagoshima Prefectures in Japan.…”

Section: Study Procedures and Participantsmentioning

confidence: 99%

“…The psychometric properties' validity and reliability of the Japanese version of PHQ-9 were reported [31,32]. We already reported a result of a factor analysis of the PHQ-9 items among current expectant women that yielded two subscales, somatic and non-somatic [26]. The somatic subscale included the items 'sleep', 'fatigue', and 'appetite', whereas the nonsomatic subscale included the items 'loss of interest', 'depressed mood', 'self-esteem', 'poor concentration', 'psychomotor', and 'suicidality'.…”

Section: Measurementsmentioning

confidence: 99%

What Are The Core Symptoms of Antenatal Depression? A Study Using Patient Health Questionnaire-9 among Japanese Pregnant Women in the First Trimester

et al. 2023

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Background: Depression is frequently seen among pregnant women. This is called antenatal depression (AND). Aim: Our aim was to identify clusters of AND and its core symptoms. Methods: The Patient Health Questionnaire-9 (PHQ-9), Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24), and Nausea and Vomiting of Pregnancy Quality of Life Questionnaire (NVP-QOL) were distributed to 382 pregnant women with a gestational age of 10 to 13 weeks who were attending antenatal clinics. The two PHQ-9 subscale scores were entered into a 2-step cluster analysis. The PHQ-9 items’ capacity to identify AND were examined in terms of the area under curve (AUC) of a receiver operating characteristic (ROC) analysis. The selected symptom items were examined for their diagnostic capability in terms of the graded response model (GRM) in the item response theory (IRT) analysis. Results: Three clusters emerged. Cluster 3 scored highly in the scores of the two PHQ-9 subscales and the two emesis scales. In the ROC, five items showed an AUC > 0.80. The GRM identified four items with high information: ‘loss of interest’, ‘depressed mood’, ‘self-esteem’, and ‘poor concentration’. Conclusions: The core symptoms of antenatal depression were four non-somatic symptoms; particularly, ‘depressed mood’ and ‘loss of interest’. AND did not exist alone, but was accompanied by nausea and vomiting. Hence, we propose a new category: emesis–depression complex among pregnant women.

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The Patient Health Questionnaire-9 among First-Trimester Pregnant Women in Japan: Factor Structure and Measurement and Structural Invariance between Nulliparas and Multiparas and across Perinatal Measurement Time Points

Cited by 3 publications

References 57 publications

Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan

Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan

Comparing the factor structures and reliabilities of the EPDS and the PHQ-9 for screening antepartum and postpartum depression: a multigroup confirmatory factor analysis

What Are The Core Symptoms of Antenatal Depression? A Study Using Patient Health Questionnaire-9 among Japanese Pregnant Women in the First Trimester

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