Department of Statistics and Operative Research, University of Salamanca, Campus Miguel de Unamuno. C/ Alfonso X El Sabio, S/N, 37007, Salamanca, Spain.
Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Virgen de la Vega, 10ª Planta, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.
Sci Rep. 2023 Aug 31;13(1):14295. doi: 10.1038/s41598-023-41560-0.
The PHQ-9 questionnaire is a screening test worldwide used to measure depression. But it cannot be used in Costa Rica, due to the fact that it has not previously been validated for its population. The present study aims to show the validation of the PHQ-9 questionnaire and its variants (PHQ-2, PHQ-4, PHQ-8) in a population sample of adults residing in Costa Rica. A sample was collected (n = 1162) using a self-administered questionnaire. Confirmatory Factor Analysis (CFA), Receiver Operating Characteristic (ROC) curve, and Multiple Group Confirmatory Factor Analysis (MGCFA) were tested. One factor was found that explained 73.33% of the variance with excellent internal consistency (α = 0.928). Goodness-of-fit measures were adequate (RMSEA = 0.107; CFI = 0.948), as was diagnostic power at a cut-off of 10 (78.60 for Sensitivity and 27.95 for 1-Specificity). External validation indices were good (r = 0.843 with GAD-7, r = - 0.647 with RS14, and r = 0.301 with FCV19S), and the model showed invariance by sex (∆χ = 27.90; df = 27; p < 0.001). Additionally, new cut-off points were proposed for PHQ-9 and its variants for Costa Rican male, female, and general populations. The PHQ-9 and its variants (PHQ-2, 4, and 8) are valid tools for detecting depression (and anxiety for PHQ-4) in Costa Rican population. In addition, new cut-off points differentiated by sex are proposed.
PHQ-9 问卷是一种全球范围内用于衡量抑郁的筛查测试。但它不能在哥斯达黎加使用，因为它之前没有针对该人群进行验证。本研究旨在展示 PHQ-9 问卷及其变体（PHQ-2、PHQ-4、PHQ-8）在哥斯达黎加居住的成年人群体样本中的验证情况。使用自填问卷收集了样本（n=1162）。对验证性因素分析（CFA）、受试者工作特征（ROC）曲线和多组验证性因素分析（MGCFA）进行了测试。发现一个因子可以解释 73.33%的方差，具有极好的内部一致性（α=0.928）。拟合优度指标适中（RMSEA=0.107；CFI=0.948），在 10 分的截断值时诊断能力也较好（敏感性为 78.60，1-特异性为 27.95）。外部验证指标良好（与 GAD-7 的 r=0.843，与 RS14 的 r=-0.647，与 FCV19S 的 r=0.301），并且该模型在性别上具有不变性（∆χ=27.90；df=27；p<0.001）。此外，还为哥斯达黎加男性、女性和一般人群提出了 PHQ-9 及其变体的新截断值。PHQ-9 及其变体（PHQ-2、4 和 8）是在哥斯达黎加人群中检测抑郁（PHQ-4 还可检测焦虑）的有效工具。此外，还提出了按性别区分的新截断值。
