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Factor structure and measurement invariance across various demographic groups and over time for the PHQ-9 in primary care patients in Spain

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González-Blanch, César and Medrano, Leonardo Adrián and Muñoz-Navarro, Roger and Ruiz-Rodríguez, Paloma and Moriana, Juan A. and Limonero, Joaquín T. and Schmitz, Florian and Cano Vindel, Antonio (2018) Factor structure and measurement invariance across various demographic groups and over time for the PHQ-9 in primary care patients in Spain. PLoS ONE, 13 (2). ISSN 0165-0327

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Official URL: https://doi.org/10.1371/journal. pone.0193356



Abstract

The Patient Health Questionnaire (PHQ-9) is a widely-used screening tool for depression in primary care settings. The purpose of the present study is to identify the factor structure of the PHQ-9 and to examine the measurement invariance of this instrument across different sociodemographic groups and over time in a sample of primary care patients in Spain. Data came from 836 primary care patients enrolled in a randomized controlled trial (PsicAP study) and a subsample of 218 patients who participated in a follow-up assessment at 3 months. Confirmatory factor analysis (CFA) was used to test one- and two-factor structures identified in previous studies. Analyses of multiple-group invariance were conducted to determine the extent to which the factor structure is comparable across various demographic groups (i.e., gender, age, marital status, level of education, and employment situation) and over time. Both one-factor and two-factor re-specified models met all the preestablished fit criteria. However, because the factors identified in the two-factor model were highly correlated (r = .86), the one-factor model was preferred for its parsimony. Multi-group CFA indicated measurement invariance across different demographic groups and across time. The present findings suggest that physicians in Spain can use the PHQ-9 to obtain a global score for depression severity in different demographic groups and to reliably monitor changes over time in the primary care setting.


Item Type:Article
Uncontrolled Keywords:Somatic symptoms, Medically unexplained symptoms, Patient Health Questionnaire (PHQ-15), Latent structure, Factor invariance, Primary care
Subjects:Medical sciences > Psychology > Psychometrics
ID Code:58477
Deposited On:10 Jan 2020 09:54
Last Modified:10 Jan 2020 09:54

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