School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon; Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia; Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan.
Arch Pediatr. 2023 Aug;30(6):401-407. doi: 10.1016/j.arcped.2023.04.007. Epub 2023 Jun 17.
Adolescence is a transitional phase that brings many psychological and physiological challenges that increase emotional vulnerability and threaten the adolescent's mental well-being. Indeed, mental illnesses, such as depression and eating disorders, show an alarming increase in prevalence after puberty. Adolescent depression is particularly concerning owing to the fact that it is a principal cause of disability among adolescents, an important risk factor for suicidality, and is associated with higher risks of present and subsequent morbidity. Our study aimed at (1) examining the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) and (2) evaluating the correlation between depression, eating disorders, stress, and other variables in a sample of Lebanese adolescents.
This cross-sectional research enlisted 555 Lebanese teenagers (15-18 years) from all Lebanese governorates (May-June 2020). The confirmatory factor analysis of the PHQ-9 scale items was carried out using the SPSS AMOS program v.24. The relative chi-square, the root mean square error of approximation (RMSEA), Tucker Lewis Index (TLI) and the comparative fit index (CFI) were all utilized as goodness-of-fit indexes.
The median age of the participants was 16.66 ± 1.00 years, with 75.7% females. Among these 555 adolescents, 62.9% had mild-to-moderate depression and 14% reported moderately severe-to-severe depression, while only 23.1% were classified as not suffering from depression. Confirmatory factor analysis of the PHQ-9 scale was conducted using the one-factor structure that is described in the literature; the fit indices obtained were acceptable as follows: χ/df= 136.26/27 =5.05, CFI=0.92, TLI=0.90 and RMSEA=0.085 [0.072-0.100]. However, the modification indices between items 6 and 9 were high; after correlating these two items, the fit indices improved more as follows: χ/df= 105.59/26=4.06, CFI=0.94, TLI=0.92 and RMSEA=0.074 [0.060-0.089]. The multivariable analysis results showed that more stress (β=0.59), female sex (β=1.54), and more binge eating (β=0.16) were significantly associated with more depression.
This study supports the validity of the PHQ-9, which presents as a reliable tool for the evaluation of depression in future epidemiological studies of Lebanese adolescents. It also elucidates the high level of depression among this age group and its correlation with modifiable and unmodifiable factors.
青春期是一个充满心理和生理挑战的过渡阶段，会增加情绪脆弱性，并威胁青少年的心理健康。事实上，抑郁症和饮食失调等精神疾病在青春期后发病率显著上升。青少年抑郁症尤其令人担忧，因为它是青少年残疾的主要原因，是自杀的重要危险因素，并且与目前和随后的发病率增加有关。我们的研究旨在：（1）检验患者健康问卷-9（PHQ-9）的心理测量特性；（2）评估黎巴嫩青少年样本中抑郁、饮食失调、压力和其他变量之间的相关性。
本横断面研究招募了来自黎巴嫩所有省份的 555 名 15-18 岁的黎巴嫩青少年（2020 年 5 月至 6 月）。使用 SPSS AMOS 程序 v.24 对 PHQ-9 量表项目进行验证性因子分析。相对卡方、近似均方根误差（RMSEA）、塔克-刘易斯指数（TLI）和比较拟合指数（CFI）均用作拟合优度指标。
参与者的中位年龄为 16.66±1.00 岁，其中 75.7%为女性。在这 555 名青少年中，62.9%有轻度至中度抑郁，14%报告中度至重度抑郁，而只有 23.1%被归类为没有抑郁。PHQ-9 量表的验证性因子分析采用文献中描述的单因素结构进行；得到的拟合指数是可以接受的，如下所示：χ/df=136.26/27=5.05，CFI=0.92，TLI=0.90，RMSEA=0.085[0.072-0.100]。然而，项目 6 和 9 之间的修正指数较高；将这两个项目相关联后，拟合指数得到了改善，结果如下：χ/df=105.59/26=4.06，CFI=0.94，TLI=0.92，RMSEA=0.074[0.060-0.089]。多变量分析结果表明，更多的压力（β=0.59）、女性（β=1.54）和更多的暴食（β=0.16）与更多的抑郁显著相关。
本研究支持 PHQ-9 的有效性，它为未来黎巴嫩青少年的流行病学研究中评估抑郁提供了一种可靠的工具。它还阐明了该年龄段人群中抑郁程度较高及其与可改变和不可改变因素的相关性。
