ArticleBMC psychiatry2021
Bidimensional structure and measurement equivalence of the Patient Health Questionnaire-9: sex-sensitive assessment of depressive symptoms in three representative German cohort studies.
Article in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Depressive Symptom Patterns and Digital Screen Exposure Among Adults in Qatar: A Cross-Sectional Study With Implications for Psychiatric and Mental Health Nursing Practice.Journal of psychiatric and mental health nursing · 2026Article
- Psychometric Validation of the PHQ-9 in Ostomy Patients and Their Informal Caregivers: Evidence From A European Multicenter Study.Nursing open · 2026Observational
- Gender differences in symptom profiles of individuals being treated for mood disorders.Journal of mood and anxiety disorders · 2025Article
- Charting the course of depression care: a meta-analysis of reliability generalization of the patient health questionnaire (PHQ- 9) as the measure.Discover mental health · 2025Article
- Beyond the beats: exploring the link between blood pressure fluctuations with anxiety, depression, and sleep.Frontiers in psychiatry · 2025Article
- Current and past depression as risk factors for incident type 2 diabetes mellitus and pre-diabetes in men and women: evidence from a longitudinal community cohort.Diabetology & metabolic syndrome · 2024Article
- Prevalence of post-acute coronavirus disease 2019 symptoms twelve months after hospitalization in participants retained in follow-up: analyses stratified by gender from a large prospective cohort.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023Article
- Tryptophan catabolites and depression in the general population: results from the Gutenberg Health Study.BMC psychiatry · 2023Article
- Mental health state and its determinants in German university students across the COVID-19 pandemic: findings from three repeated cross-sectional surveys between 2019 and 2021.Frontiers in public health · 2023Article
- A Changing Home: A Cross-Sectional Study on Environmental Degradation, Resettlement and Psychological Distress in a Western German Coal-Mining Region.International journal of environmental research and public health · 2022Article
- Psychometric Properties and Factor Structure of the Patient Health Questionnaire-9 as a Screening Tool for Depression Among Ecuadorian College Students.Frontiers in psychology · 2022Article
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19 authors.
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Abstract
backgroundThe Patient Health Questionnaire-9 (PHQ-9) has been proposed as a reliable and valid screening instrument for depressive symptoms with one latent factor. However, studies explicitly testing alternative model structures found support for a two-dimensional structure reflecting a somatic and a cognitive-affective dimension. We investigated the bidimensional structure of the PHQ-9, with a somatic (sleeping problems, fatigability, appetitive problems, and psychomotor retardation) and a cognitive-affective dimension (lack of interest, depressed mood, negative feelings about self, concentration problems, and suicidal ideation), and tested for sex- and regional-differences.
methodsWe have included data from the GEnder-Sensitive Analyses of mental health trajectories and implications for prevention: A multi-cohort consortium (GESA). Privacy-preserving analyses to provide information on the overall population and cohort-specific information and analyses of variance to compare depressive, somatic and cognitive-affective symptoms between sexes and cohorts were executed in DataSHIELD. In order to determine the dimensionality and measurement invariance of the PHQ-9 we tested three models (1 factor, 2 correlated factors, and bifactor) via confirmatory analyses and performed multi-group confirmatory factor analysis.
resultsDifferences between sex and cohorts exist for PHQ-9 and for both of its dimensions. Women reported depressive symptoms in general as well as somatic and cognitive-affective symptoms more frequently. For all tested models an acceptable to excellent fit was found, consistently indicating a better model fit for the two-factor and bifactor model. Scalar measurement invariance was established between women and men, the three cohorts, and their interaction.
conclusionsThe two facets of depression should be taken into account when using PHQ-9, while data also render support to a general factor. Somatic and cognitive-affective symptoms assessed by the PHQ-9 can be considered equivalent across women and men and between different German populations from different regions.
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