Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context
Summary: Background: The 8-item version of the Patient Health Questionnaire (PHQ-8) is one of the self-reported questionnaires most frequently used worldwide for the screening and severity assessment of depression. However, in some European countries its reliability is unknown, and it is unclear wh...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | The Lancet Regional Health. Europe |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776223000789 |
| _version_ | 1797809129037758464 |
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| author | Jorge Arias de la Torre Gemma Vilagut Amy Ronaldson Jose M. Valderas Ioannis Bakolis Alex Dregan Antonio J. Molina Fernando Navarro-Mateu Katherine Pérez Xavier Bartoll-Roca Matilde Elices Víctor Pérez-Sola Antoni Serrano-Blanco Vicente Martín Jordi Alonso |
| author_facet | Jorge Arias de la Torre Gemma Vilagut Amy Ronaldson Jose M. Valderas Ioannis Bakolis Alex Dregan Antonio J. Molina Fernando Navarro-Mateu Katherine Pérez Xavier Bartoll-Roca Matilde Elices Víctor Pérez-Sola Antoni Serrano-Blanco Vicente Martín Jordi Alonso |
| author_sort | Jorge Arias de la Torre |
| collection | DOAJ |
| description | Summary: Background: The 8-item version of the Patient Health Questionnaire (PHQ-8) is one of the self-reported questionnaires most frequently used worldwide for the screening and severity assessment of depression. However, in some European countries its reliability is unknown, and it is unclear whether its psychometric properties vary between European countries. Therefore, the aim of this study was to assess the internal structure, reliability and cross-country equivalence of the PHQ-8 in Europe. Methods: All participants from the 27 countries included in the second wave of the European Health Interview Survey (EHIS-2) between 2014 and 2015 with complete information on the PHQ-8 were included (n = 258,888). The internal structure of the PHQ-8 was assessed using confirmatory factor analyses (CFA) for categorical items. Additionally, the reliability of the questionnaire was assessed based on the internal consistency, Item Response Theory information functions, and item-discrimination (using Graded Response Models), and the cross-country equivalence based on multi-group CFA. Findings: The PHQ-8 shows high internal consistency for all countries. The countries in which the PHQ-8 was more reliable were Romania, Bulgaria and Cyprus and less reliable were Iceland, Norway and Austria. The PHQ-8 item with highest discrimination was item 2 (feeling down, depressed, or hopeless) in 24 of the 27 countries. Measurement invariance between countries in Europe was observed from multigroup CFA at the configural, metric and scalar levels. Interpretation: The results from our study, likely the largest study to the date assessing the internal structure, reliability and cross-country comparability of a self-reported mental health assessment measure, shows that the PHQ-8 has an adequate reliability and cross-country equivalence across the 27 European countries included. These results highlight the suitability of the comparisons of the PHQ-8 scores in Europe. They could be helpful to improve the screening and severity assessment of depressive symptoms at the European level. Funding: This work was partially funded by CIBER Epidemiology and Public Health (CIBERESP) as part of the Intramural call of 2021 (ESP21PI05). |
| first_indexed | 2024-03-13T06:47:56Z |
| format | Article |
| id | doaj.art-f7de01a8071547309a5773348f653ef6 |
| institution | Directory Open Access Journal |
| issn | 2666-7762 |
| language | English |
| last_indexed | 2024-03-13T06:47:56Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj.art-f7de01a8071547309a5773348f653ef62023-06-08T04:19:57ZengElsevierThe Lancet Regional Health. Europe2666-77622023-08-0131100659Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in contextJorge Arias de la Torre0Gemma Vilagut1Amy Ronaldson2Jose M. Valderas3Ioannis Bakolis4Alex Dregan5Antonio J. Molina6Fernando Navarro-Mateu7Katherine Pérez8Xavier Bartoll-Roca9Matilde Elices10Víctor Pérez-Sola11Antoni Serrano-Blanco12Vicente Martín13Jordi Alonso14Care in Long Term Conditions Research Division, King’s College London, London, UK; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain; Corresponding author. JCMB, Second Floor, Office 2.16. 57 Waterloo Road, London SE1 8WA, UK.CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, SpainInstitute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UKDepartment of Medicine, National University of Singapore, Singapore; Department of Family Medicine, National University Health System, Singapore; Centre for Research in Health Systems Performance (CRiHSP), National University Health System, SingaporeInstitute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UKInstitute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UKCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institute of Biomedicine (IBIOMED), University of Leon, Leon, SpainCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, Murcia, Spain; IMIB-Arrixaca, Murcia, SpainCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, SpainAgència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut de Recerca de l’Hospital de laSanta Creu i Sant Pau, Barcelona, SpainCIBER Mental Health (CIBERSAM), Madrid, SpainCIBER Mental Health (CIBERSAM), Madrid, SpainCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, SpainCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institute of Biomedicine (IBIOMED), University of Leon, Leon, SpainCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, SpainSummary: Background: The 8-item version of the Patient Health Questionnaire (PHQ-8) is one of the self-reported questionnaires most frequently used worldwide for the screening and severity assessment of depression. However, in some European countries its reliability is unknown, and it is unclear whether its psychometric properties vary between European countries. Therefore, the aim of this study was to assess the internal structure, reliability and cross-country equivalence of the PHQ-8 in Europe. Methods: All participants from the 27 countries included in the second wave of the European Health Interview Survey (EHIS-2) between 2014 and 2015 with complete information on the PHQ-8 were included (n = 258,888). The internal structure of the PHQ-8 was assessed using confirmatory factor analyses (CFA) for categorical items. Additionally, the reliability of the questionnaire was assessed based on the internal consistency, Item Response Theory information functions, and item-discrimination (using Graded Response Models), and the cross-country equivalence based on multi-group CFA. Findings: The PHQ-8 shows high internal consistency for all countries. The countries in which the PHQ-8 was more reliable were Romania, Bulgaria and Cyprus and less reliable were Iceland, Norway and Austria. The PHQ-8 item with highest discrimination was item 2 (feeling down, depressed, or hopeless) in 24 of the 27 countries. Measurement invariance between countries in Europe was observed from multigroup CFA at the configural, metric and scalar levels. Interpretation: The results from our study, likely the largest study to the date assessing the internal structure, reliability and cross-country comparability of a self-reported mental health assessment measure, shows that the PHQ-8 has an adequate reliability and cross-country equivalence across the 27 European countries included. These results highlight the suitability of the comparisons of the PHQ-8 scores in Europe. They could be helpful to improve the screening and severity assessment of depressive symptoms at the European level. Funding: This work was partially funded by CIBER Epidemiology and Public Health (CIBERESP) as part of the Intramural call of 2021 (ESP21PI05).http://www.sciencedirect.com/science/article/pii/S2666776223000789DepressionPatient Health QuestionnaireEuropeReliabilityValidityHealth surveys |
| spellingShingle | Jorge Arias de la Torre Gemma Vilagut Amy Ronaldson Jose M. Valderas Ioannis Bakolis Alex Dregan Antonio J. Molina Fernando Navarro-Mateu Katherine Pérez Xavier Bartoll-Roca Matilde Elices Víctor Pérez-Sola Antoni Serrano-Blanco Vicente Martín Jordi Alonso Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context The Lancet Regional Health. Europe Depression Patient Health Questionnaire Europe Reliability Validity Health surveys |
| title | Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context |
| title_full | Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context |
| title_fullStr | Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context |
| title_full_unstemmed | Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context |
| title_short | Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in EuropeResearch in context |
| title_sort | reliability and cross country equivalence of the 8 item version of the patient health questionnaire phq 8 for the assessment of depression results from 27 countries in europeresearch in context |
| topic | Depression Patient Health Questionnaire Europe Reliability Validity Health surveys |
| url | http://www.sciencedirect.com/science/article/pii/S2666776223000789 |
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