Profiles of depression in a treatment-seeking Hispanic population: Psychometric properties of the Patient Health Questionnaire-9.
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ABSTRACT: Objectives
Screening instruments can be powerful tools in assisting primary care providers with detecting depression in their patients and monitoring treatment response. Health disparities among racial and ethnic minorities result from inaccurate assessment in primary care.Methods
The current study used baseline data from two federally funded research studies of treatment for depression among Hispanics in primary care. The Patient Health Questionnaire-9 (PHQ-9) was administered at baseline prior to the study interventions, and 499 participants provided responses.Results
Confirmatory factor analyses found excellent factor validity for the PHQ-9, yet reliability remained poor. Possible heterogeneity in depressive item scores was examined, and latent profile analysis identified four distinct profiles of PHQ-9 responses. Profiles included a lower depression, moderate/somatization, moderate/negative self-view, and severe depression profiles. Results indicate modest support for the PHQ-9 and its use among Hispanics for the purpose of depression screening.Conclusion
Capturing four profiles of depression in a large primary care sample helps characterize the manifestation of depression in a Hispanic population. The single item related to fatigue had the greatest variation across groups indicating it might be useful as a screening item. Inadequate evaluation of symptoms could lead to significant under identification of the disorder among Hispanics.
SUBMITTER: Killian MO
PROVIDER: S-EPMC7992282 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background The Patient Health Questionnaire-9 (PHQ-9) is the most well-known self-report measure to screen for depressive symptomatology, although discerning which is the factor structure that represents the best fit remains a challenge. Objective The aim of this study was to analyze the psychometric properties and factorial structure of the Spanish version of the PHQ-9 in a large sample of Ecuadorian college students. Methods A total of 5,394 students (M = 22.03 years; SD = 3.05; 54.8% female) from three Ecuadorian universities were surveyed using a computerized questionnaire within a 4-week assessment period. The PHQ-9 was tested for factorial structure, reliability, and correlations with other mental health-related measures. Results The hierarchical model that included a general factor and three nested factors had a better fit, and such a hierarchical structure remained invariant across sex and age. Total omega value (ω) was 0.90 for the total scale and hierarchical omega values (ωh) were 0.68 for the general factor, as well as 0.34, 0.38, and 0.44 for the respective nested factors (somatic, cognitive/affective, concentration/motor). Moreover, PHQ-9 scores were significantly higher among women, although effect sizes of comparison of those sex differences were very small. Finally, the PHQ-9 scores correlated with multiple mental health indicators (psychological inflexibility, loneliness, stress, and satisfaction with life). Discussion The Spanish version of the PHQ-9 showed good psychometric properties among Ecuadorian college students. The hierarchical structure showed the best fit for the data, including not only a dominant general factor, but also the somatic, cognitive/affective and concentration/motor subcomponents. In conclusion, the PHQ-9 tool seems to represent an easy-to-implement screening questionnaire to design preventive programs for those Ecuadorian college students at risk of developing depressive disorders.
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Project description:Prodromal Questionnaire (PQ) and Structured Interview for Prodromal Syndromes (SIPS) have been used as a two-stage process for identifying subjects at clinical high risk (CHR) of psychosis. The Prodromal Questionnaire-Brief version (PQ-B) contains 21 items derived from the PQ. The present study aimed to examine the psychometric properties of PQ-B in a Chinese help-seeking outpatient sample and to explore which items can better predict CHR diagnosis by SIPS and future transition to psychosis. In our preliminary epidemiological study, 1461 patients from a pool of 2101 individuals (15-45 years of age) completed the two-stage process. In the present study, 239 (20%) people were randomly selected among the sample who met the initial PQ-B screening criteria but had no positive diagnosis on SIPS, as well as 72 individuals with negative results on both PQ-B and SIPS, 89 prodromal and 105 psychotic subjects, yielding a total of 505 participants. The internal consistency coefficient for the PQ-B was good, with a Cronbach's alpha of 0.897. The concordant validity of PQ-B with SIPS dichotomized diagnosis of prodrome/psychosis versus no psychosis was 0.54. To ensure 80% or a higher sensitivity and a certain specificity, 7 and 24 were respectively set as the cutoff points for the PQ-B total score and distress score for Chinese help-seeking outpatients. A logistic regression model based on six PQ-B items could allow predicting the psychotic diagnosis on SIPS, with an accuracy of 65.8%. Prodromal individuals who scored higher on the 12th item of PQ-B (Do you worry at times that something may be wrong with your mind?) were less likely to convert to psychosis. PQ-B is a useful instrument for screening CHR subjects, but the cutoff score may be higher than that recommended by the author scores for help-seeking individuals in outpatient clinics. Some specific PQ-B items may have significant predictive power on dichotomized SIPS diagnoses and deserve special attention from researchers in future studies.
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Project description:BackgroundTrust has been introduced as the cornerstone of the public and health providers' relation. Public trust in primary health care (PHC) is crucial and must be measured. The aim of this study was to develop and validate PHC trust measurement tool.MethodsThis was a psychometric study to develop PHC trust measuring tool done in Tabriz, East-Azerbaijan with participation of 600 households in 2016. Item generation was done through literature review and experts opinions. The content validity, reliability and construct validity of the PHC trust tool were assessed using several statistical methods including modified Kappa, Kendall's Tau and intra-class correlation coefficient (ICC) as well as exploratory factor analysis (EFA). Data were analyzed using STATA 14 statistical software package.ResultsA 30-item questionnaire was developed. The Modified Kappa coefficient as an indicator of content validity assessment was 0.94. With respect to reliability assessment, a high internal consistency was observed with 0.98 Cronbach-Alpha score and the test-retest reliability for overall scale (assessed by ICC) was 0.94 (CI: 0.87-0.97). Exploratory factor analysis emerged 2 factors. Factor 1 consisted of 25 items accounting for 74.1% of the variance (eigenvalue = 22.47) followed by Factor 2 consisting of 5 items accounting for 19.2% of the variance (eigenvalue = 1.6).ConclusionPHC trust measuring tool could be used as a valid and reliable tool by health systems in Iran and similar contexts to investigate how they are trustful from the public viewpoint.
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Project description:ObjectivesThe Patient Health Questionnaire-9 Modified (PHQ-9M) is a self-report tool used to assess the presence and severity of depressive symptoms in teenagers. Despite widespread use in primary care clinics and psychiatric settings, the PHQ-9M has not been validated nor are its psychometric properties adequately understood for the adolescent population. This study sought to examine the psychometrics of the PHQ-9M in treatment-seeking, depressed adolescents at a psychiatric psychopharmacology clinic who were concurrently assessed with the Children's Depression Rating Scale Revised (CDRS-R) and Quick Inventory of Depressive Symptomatology-Adolescent (17-item) Self-Report (QIDS-A17-SR).MethodsAdolescents (N?=?160) aged 13 through 18 years with a diagnosis of major depressive disorder, determined on the basis of a clinical interview and semi-structured interview using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, were assessed for severity of depressive symptoms with the PHQ-9M, CDRS-R (adolescent interview only), and QIDS-A17-SR assessments at baseline, 4, and 8 weeks. Classical test theory analysis was used to evaluate the internal consistency and dimensionality of the PHQ-9M. Convergent validity was evaluated via intraclass correlations of the PHQ-9M with the CDRS-R and QIDS-A17-SR. Sensitivity to treatment response was also evaluated.ResultsThe internal consistency (Cronbach's coefficient ?) at baseline, 4, and 8 weeks was 0.879, 0.859, and 0.827 for the PHQ-9M; 0.739, 0.835, and 0.867 for CDRS-R; and 0.712, 0.777, and 0.804 for QIDS-A17-SR, respectively. The PHQ-9M had moderate convergent validity with the CDRS-R but good convergent validity with the QIDS-A17-SR. The PHQ-9M was less sensitive to changes in symptom severity than the CDRS-R and QIDS-A17-SR.ConclusionsThe PHQ-9M appears to be a valid and reliable assessment tool for the severity of depressive symptoms in a psychiatric clinic setting. However, its utility as a treatment outcome measure may be limited compared with other available rating scales.
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Project description:BackgroundThe Mood and Feelings Questionnaire (MFQ) is a widely used screening tool for child and adolescence depression but has not been validated with young people in Thailand. This study aimed to assess the reliability and validity and to determine the optimal clinical cut-off of the Thai MFQ.MethodsThe Thai MFQ was evaluated in two parts. In part 1, The MFQ was translated and back translated into the Thai language and piloted on a small number of Thai adolescents. Then 1275 young people aged 12-18 years from three secondary schools in Thailand completed the MFQ and related measures of depression. In part 2, 138 students were invited to take part in a structured diagnostic interview (the Thai translation of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children -Present and Lifetime Version (the K-SADS-PL). Of those, 103 students were interviewed and completed the Thai MFQ a second time to assess test-retest reliability. Receiver Operating Characteristics (ROC) analyses were conducted to evaluate diagnosis accuracy and examine the optimal cut-off score of the Thai MFQ.ResultsThe Thai MFQ had excellent internal consistency (α = 0.92) and good to moderate test-retest reliability in 2-week and 4-week intervals. The Thai MFQ also had good convergent validity with related measures of depression. The ROC analyses demonstrated that the Thai MFQ also had excellent accuracy distinguishing between depressed and non-depressed adolescents [AUC = 0.95, 95% CI [0.92, 0.99]. A total score of 28 on the Thai MFQ was the optimal cut-off score (sensitivity was 0.97 and specificity was 0.83).DiscussionThe Thai MFQ demonstrated excellent psychometric properties and accurately distinguished between depressed and non-depressed adolescents. It is appropriate to use as a screening measure to identify adolescents with depression in community settings in Thailand.
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Project description:OBJECTIVE:To assess the psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire. METHODS:This study was a cross-sectional, multinational study. Participants were enrolled if they were more than 10 years old and people with haemophilia A or B or people without a bleeding disorder. Participants were invited through non-governmental patient organisations in 21 countries between 01/27/2016 and 02/23/2017. The following psychometric properties: missing data, floor and ceiling effects, exploratory factor analysis and internal consistency reliability were examined. A PROBE Score was derived and assessed for its convergent and known groups validity. RESULTS:The study analysed the data on 916 participants with median age of 37.0 (IQR 27.0 to 48.0) years, 74.8% male. In the domain assessing patient-reported outcomes (PROs), more than 15% of participants presented a ceiling effect for all items but two, and a floor effect for one item. Factor analysis identified three factors explaining the majority of the variance. Cronbach's alpha coefficient indicated good internal consistency reliability (0.84). PROBE items showed moderate to strong correlations with corresponding EuroQol five dimension 5-level instrument (EQ-5D-5L) domains. The PROBE Score has a strong correlation (r=0.67) with EQ-5D-5L utility index score. The PROBE Score has a known groups validity among various groups. CONCLUSIONS:The results of this study suggest that PROBE is a valid questionnaire for evaluating PROs in people with haemophilia as well as control population. The known-group property of PROBE will allow its use in future clinical trials, longitudinal studies, health technology assessment studies, routine clinical care or registries. Additional studies are needed to test responsiveness and sensitivity to change. TRIAL REGISTRATION NUMBER:NCT02439710; Results.
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Project description:BackgroundThe Back Beliefs Questionnaire (BBQ) is a 14-item patient-reported questionnaire that measures attitudes and beliefs about the consequences of back pain. The BBQ has recently been translated into Norwegian, but its psychometric properties have not yet been tested. The aim of this study is to evaluate the reliability and construct validity of the BBQ when used on elderly patients with back pain.MethodA prospective cohort study with a test-retest design among 116 elderly patients (> 55 years of age) seeking primary care for a new episode of back pain. Test-retest, standard error of measurement (SEM), minimal detectable change (MDC), internal consistency and construct validity by a priori hypotheses (Spearman's- and Pearson correlation coefficient) were tested.ResultsA total of 116 patients, mean age (SD) 67.7 (8.3), were included and 63 patients responded to the test-retest assessment. The mean (SD) BBQ sum scores (range 9-45) were 29.8 (7.0) and 29.2 (6.7) for the test and retest respectively. The test-retest was acceptable with an intraclass correlation coefficient of 0.71 (95% CI, 0.54-0.82), SEM was 3.8 and MDC 10.5. Internal consistency with Cronbach's alpha was good (0.82) and acceptable construct validity was supported by the confirmation of 75% of the a priori hypotheses.ConclusionThe Norwegian version of the BBQ demonstrated acceptable test-retest reliability and good construct validity and can be used to assess pessimistic beliefs in elderly patients with back pain.
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Project description:AimsThe aim of this study was to assess the psychometric properties of the revised self-rated version of the Dysexecutive Questionnaire (DEX-R) within a non-clinical sample.MethodsThe study was hosted online, with 140 participants completing the DEX-R, GAD-2 and PHQ-2. Sixty participants also completed the FrSBe, with 99 additionally completing the DEX-R again 3 weeks later. Correlations with demographic factors and symptoms of anxiety and depression were conducted. Rasch and factor analysis were also used to explore underlying subconstructs.ResultsThe DEX-R correlated highly with the FrSBe, indicating sound concurrent validity. Internal consistency, split-half reliability and test-retest reliability were excellent. Age and symptoms of depression and anxiety correlated with DEX-R scores, with older age associated with less dysexecutive problems. The Rasch analysis confirmed the multidimensionality of the rating scale, and a three-factor structure was found relating to activation-self-regulatory, cognitive and social-emotional processes. Frequencies of responses on DEX-R items varied, many were not fully endorsed indicating specific relevance of most but not all items to patients.ConclusionInterpretations of DEX-R ratings of dysexecutive problems should consider mood and individual variation. Systematic comparison of DEX-R responses between healthy and clinical groups could help identify a suitable cut off for dysexecutive symptoms.
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Project description:BackgroundChildbirth preparation classes can reduce pregnant women's anxiety and fear for their childbirth. However, to evaluate women's feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population.MethodsThe questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37?weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire.ResultsThe impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach's alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire.ConclusionThe Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women's satisfaction with childbirth education classes.
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Project description:BackgroundPerson-centered care is a valuable approach to improve the quality of care of the elderly and is a starting point for maintaining the dignity of people needing care.ObjectivesThis study aimed at translation, cultural adaptation, and validation of the Persian version of the Person-centered Climate Questionnaire-Patient questionnaire in elderly patients admitted to the Eastern Guilan hospitals from 2017-2018.DesignThis research was a cross-sectional study. The Persian version of Person-centered Climate Questionnaire -Patient version was completed by 200 older adults admitted to different wards of the hospitals. They were selected through convenient sampling. Data were collected in 5 hospitals affiliated to Guilan University of Medical Sciences, East of Guilan located in the north of Iran, from November 2017 to February 2018.MethodsThis study was carried out in two phases. In the first phase, the original questionnaire with 17 items was translated from English into Persian using Forward-Backward translation method. In the second phase, the psychometric properties of the questionnaire were evaluated using face, content, and construct validity, as well as reliability (internal consistency and stability). Data were analyzed via SPSS software v.16.ResultsThe results of exploratory factor analysis (EFA) led to retaining 17 items with three factors of "Safety", "Hospitality", and "Everydayness" which explained 47.69% of the total variance. Cronbach's alpha coefficient was calculated for each factor (0.85, 0.70, and 0.64, respectively) as well as the whole instrument (0.85), to ensure internal consistency. Stability was confirmed by calculating the intra-class correlation coefficient as 0.99.ConclusionsThe current study found support for assessing the person-centered climate from the perspective of the elderly patients by using the Persian version of the Person-centered Climate Questionnaire-Patient that has an appropriate cultural adaptation, validity, and reliability.
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