OBJECTIVE:The Patient Health Questionnaire depression scale (PHQ-9) is a well-validated, Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criterion-based measure for diagnosing depression, assessing severity and monitoring treatment response. The performance of most depression scales including the PHQ-9, however, has not been rigorously evaluated in different racial/ethnic populations. Therefore, we compared the factor structure of the PHQ-9 between different racial/ethnic groups as well as the rates of endorsement and differential item functioning (DIF) of the 9 items of the PHQ-9. The presence of DIF would indicate that responses to an individual item differ significantly between groups, controlling for the level of depression. MEASUREMENTS:A combined dataset from 2 separate studies of 5,053 primary care patients including non-Hispanic white (n =2,520), African American (n =598), Chinese American (n =941), and Latino (n =974) patients was used for our analysis. Exploratory principal components factor analysis was used to derive the factor structure of the PHQ-9 in each of the 4 racial/ethnic groups. A generalized MantelHaenszel statistic was used to test for DIF. RESULTS:One main factor that included all PHQ-9 items was found in each racial/ethnic group with a coefficients ranging from 0.79 to 0.89. Although endorsement rates of individual items were generally similar among the 4 groups, evidence of DIF was found for some items. CONCLUSIONS:Our analyses indicate that in African American, Chinese American, Latino, and non-Hispanic white patient groups the PHQ-9 measures a common concept of depression and can be effective for the detection and monitoring of depression in these diverse populations.

The dumpy gene encodes a gigantic extracellular molecule that we predict to be a membrane-anchored fibre of almost a micrometer in length. Insertion and crosslinking of this fibre within the cuticle may provide a strong anchor for the underlying tissue, allowing it to maintain mechanical tension at sites under stress. This would explain its contribution to tissue morphogenesis through its regulation of mechanical properties.

Asian American communities have important and unmet mental health needs, but there is comparatively little research data on process and outcomes that can guide evidence-based approaches to mental health care. This paper describes our experience of building research programs in a community-based health care facility, some of the challenges we faced, and barriers that were overcome. We have learned that a) mental health services research can be carried out in a community health center with minimal intrusion on usual patient flow; b) the effort must be shared between the health center and the community; c) barriers to participation in mental health research programs are multifactorial ranging from conceptual, cultural, and attitudinal biases to practical concerns inherent in the ethnic minority population; and d) resistance can be overcome by working with participants' cultural and social needs and using their explanatory belief models when developing and pursuing studies.

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