Havnen Audun, Lydersen Stian, Mandahl Arthur, Lara-Cabrera Mariela Loreto
Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
Nidaros Division of Psychiatry, Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway.
Front Psychiatry. 2023 Jul 14;14:1176298. doi: 10.3389/fpsyt.2023.1176298. eCollection 2023.
Persons with attention-deficit/hyperactivity disorder (ADHD) frequently experience symptoms of anxiety and depression. In this population, there is a need for validated brief self-report screening questionnaires to assess the severity of comorbid mental health problems. The Patient Health Questionnaire 4 (PHQ-4) is a self-report questionnaire that may contribute to this purpose as it can screen for both disorders efficiently. However, this will be the first study examining the factor structure of the PHQ-4 in samples of adults with ADHD, and also evaluating the validity of the Norwegian version of the PHQ-4.
The aim of the current cross-sectional study was to examine the factor structure and validity of the Norwegian version of the PHQ-4 in a sample of adults who reported having been diagnosed with ADHD.
Of 496 invited, a total of 326 participants (66%) completed the PHQ-4, The World Health Organization Five Well-Being Index, the Oslo Social Support Scale and the 4-item Perceived Stress Scale electronically in a web-portal between the 9th and 30th of June 2020.
Confirmatory factor analysis of the PHQ-4 supported a two-factor structure [RMSEA = 0.038 (90% CI 0.000-0.159), CFI = 1.00, TLI = 0.999, SRMR = 0.004], consisting of a depression factor and an anxiety factor. Standardized factor loadings were 0.79 to 0.97. The PHQ-4 was negatively correlated with well-being and social support and positively correlated with perceived level of stress.
This study indicates promising psychometric properties of the PHQ-4 as a measure of anxiety and depressive symptoms in adults with self-reported ADHD who are fluent in Norwegian. The questionnaire's brevity makes it a valuable resource in research and clinical settings. However, more studies are needed to test the instrument in a clinical sample.
注意力缺陷多动障碍（ADHD）患者经常出现焦虑和抑郁症状。在这一人群中，需要经过验证的简短自我报告筛查问卷来评估共病心理健康问题的严重程度。患者健康问卷4（PHQ - 4）是一份自我报告问卷，因其能够有效筛查这两种疾病，可能有助于实现这一目的。然而，这将是第一项研究成人ADHD样本中PHQ - 4的因子结构，并评估挪威版PHQ - 4有效性的研究。
当前横断面研究的目的是在报告被诊断患有ADHD的成人样本中，检验挪威版PHQ - 4的因子结构和有效性。
在496名受邀者中，共有326名参与者（66%）于2020年6月9日至30日期间在网络平台上以电子方式完成了PHQ - 4、世界卫生组织五福指数、奥斯陆社会支持量表和4项感知压力量表。
PHQ - 4的验证性因子分析支持两因子结构[RMSEA = 0.038（90% CI 0.000 - 0.159），CFI = 1.00，TLI = 0.999，SRMR = 0.004]，由一个抑郁因子和一个焦虑因子组成。标准化因子载荷为0.79至0.97。PHQ - 4与幸福感和社会支持呈负相关，与感知压力水平呈正相关。
本研究表明，对于能流利使用挪威语且自我报告患有ADHD的成年人，PHQ - 4作为焦虑和抑郁症状的测量工具具有良好的心理测量特性。该问卷简短，使其在研究和临床环境中成为一种有价值的资源。然而，需要更多研究在临床样本中测试该工具。
