TY - JOUR
T1 - Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries
T2 - Findings from the ESTSS ADJUST study
AU - Kazlauskas, Evaldas
AU - Gelezelyte, Odeta
AU - Kvedaraite, Monika
AU - Ajdukovic, Dean
AU - Johannesson, Kerstin Bergh
AU - Böttche, Maria
AU - Bondjers, Kristina
AU - Dragan, Małgorzata
AU - Figueiredo-Braga, Margarida
AU - Grajewski, Piotr
AU - Anastassiou-Hadjicharalambous, Xenia
AU - Javakhishvili, Jana Darejan
AU - Lioupi, Chrysanthi
AU - Lueger-Schuster, Brigitte
AU - Mouthaan, Joanne
AU - Bagaric, Ines Rezo
AU - Sales, Luisa
AU - Schäfer, Ingo
AU - Soydas, Suzan
AU - Tsiskarishvili, Lela
AU - Zrnic Novakovic, Irina
AU - Lotzin, Annett
N1 - Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/8/15
Y1 - 2023/8/15
N2 - Background: The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used screening measure for depression and anxiety. Objectives: This study aimed to test factor structure and measurement invariance in an adult sample of the general population across seven European countries. Method: A total sample of 9230 adults, 71.3 % female, Mage = 44.35 (SD = 14.11) from seven countries (Austria, Croatia, Georgia, Germany, Lithuania, Portugal, and Sweden) participated in the study. We applied confirmatory factor analysis (CFA) to examine the factor structure and measurement invariance testing to evaluate measurement equivalence across countries, gender, and age groups. Results: The CFA yielded that a two-factor PHQ-4 model with separate depression and anxiety factors had the best fit. Partial scalar measurement invariance was established across different groups based on gender, age, and country. Conclusions: The PHQ-4 is a valid and reliable measure that can be applied to screen for depression and anxiety in the general population. Limitations: The limitation of the study includes the sampling, which resulted in the sample structure with the majority of females, predominantly of high education and from urban communities.
AB - Background: The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used screening measure for depression and anxiety. Objectives: This study aimed to test factor structure and measurement invariance in an adult sample of the general population across seven European countries. Method: A total sample of 9230 adults, 71.3 % female, Mage = 44.35 (SD = 14.11) from seven countries (Austria, Croatia, Georgia, Germany, Lithuania, Portugal, and Sweden) participated in the study. We applied confirmatory factor analysis (CFA) to examine the factor structure and measurement invariance testing to evaluate measurement equivalence across countries, gender, and age groups. Results: The CFA yielded that a two-factor PHQ-4 model with separate depression and anxiety factors had the best fit. Partial scalar measurement invariance was established across different groups based on gender, age, and country. Conclusions: The PHQ-4 is a valid and reliable measure that can be applied to screen for depression and anxiety in the general population. Limitations: The limitation of the study includes the sampling, which resulted in the sample structure with the majority of females, predominantly of high education and from urban communities.
KW - Anxiety
KW - Confirmatory factor analysis
KW - Depression
KW - Measurement invariance
KW - PHQ-4
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85158002644&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2023.05.007
DO - 10.1016/j.jad.2023.05.007
M3 - Article
C2 - 37164064
AN - SCOPUS:85158002644
SN - 0165-0327
VL - 335
SP - 18
EP - 23
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -