ArticlePsicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS2024
Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population.
Article in Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry.Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS · 2026Article
- Demographic variation in symptoms of depression and anxiety across 22 Global Flourishing Study countries.Communications medicine · 2026Article
- Article
- Financial toxicity, family resilience and symptom burden in liver cancer patients: a cross-sectional study.Frontiers in psychology · 2025Article
- Use of the PHQ-4 Tool to Assess Anxiety and Depression in Adolescents and Adults During a Medical Brigade in Medically Underserved Santo Domingo, Ecuador.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
11 authors at 11 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings.
objectiveThis study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics.
methodsA total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women.
resultsThe results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups.
conclusionThe PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.