Construct validity and differential item functioning of the PHQ-9 among health care workers: Rasch Analysis approach

Abstract

Background The Patient Health Questionnaire (PHQ-9) is a widely used self-report questionnaire to screen depression. Its psychometric property has been tested in many populations including health care workers. We used Rasch measurement theory to examine the psychometric properties of PHQ-9 regarding item difficulty, item fit and the differences between subgroups of respondents classified by sex, age, education and alcohol user status, based on the same overall location of participants.Methods In total, 3,204 health care workers of Maharaj Nakorn Chiang Mai Hospital participated and were administered the PHQ-9. Rating scale Rasch measurement modeling was used to examine the psychometric properties of the PHQ-9.Results The data fitted well to the Rasch model and no violations of the assumption of unidimensionality were observed. All 9 items could form a unidimensional construct of overall depressive severity. Suicidal ideation was the least endorsed while sleep problem was the most. No disordered category and threshold of the rating response were observed. No locally dependent items were observed. No items were found to show differential item functioning across age, sex, education and alcohol consumption. The item-person Wright map showed that the PHQ-9 did not target well with the sample, and a wide gap suggesting few or no items exist to differentiate participants at a certain ability level among the PHQ-9 items.Conclusion The PHQ-9 can be used as a screening questionnaire for major depressive disorder as its psychometric property was verified based on Rasch measurement model. The findings are generally consistent with related studies in other populations. However, the PHQ-9 may be unsuitable for assessing depressive symptoms among health care workers who have low levels of depression.

Borderline Personality Symptoms: What Not to Be Overlooked When Approaching Suicidal Ideation among University Students

“…Some may argue that suicidality is one part of depression. This is absolutely true as it could be found in high levels of depression based on symptom hierarchy [56]. However, for those exhibiting borderline personality, suicidality may be present in a milder form of depression [57,58].…”

Prevalence of depression symptoms among staff at the city institute for emergency medical services Belgrade

“…(Tabela 7) Tabela 6. Upotreba antidepresivima kod ispitanika Diskusija: Ograničenje ovog istraživanja je upravo izbor standardizovanog Upitnika PHQ-9 kao alata za istraživanje, za koji su Jiraniramai S, Wongpakaran T, Angkurawaranon C, Jiraporncharoen W, Wongpakaran N, testirajući ga Rašovom teorijom merenja, zaključili da može biti neprikladan za procenu simptoma depresije među zdravstvenim radnicima koji imaju nizak nivo depresije [21] . Takođe se postavlja pitanje iskrenosti ispitanika prilikom popunjavanja upitnika, s obzirom na stigmatizaciju psihičkih problema koja postoji posebno kod zdravstvenih radnika.…”

“…Kod zaposlenih u administraciji blagi i umereni simptomi depresije, posmatrajući procentualnu zastupljenost, češće su prisutni nego kod ispitanika u "operativi" (administracija: 14,81%; 7,41%, a "operativa": 6,76%; 1,35%) dok je u apsolutnim brojevima takođe ta razlika beznačajna (administracija: 4 ispitanika i 2 ispitanika, a "operativa": 5 ispitanika i 1 ispitanik). Kao instrument ovog istraživanja koristili smo standardizovani upitnik PHQ-9 [27] , koji su Jiraniramai S, Wongpakaran T, Angkurawaranon C, Jiraporncharoen W, Wongpakaran N. testirali Rašovom teorijom merenja i zaključili da se PHQ-9 upitnik može koristiti kao skrining upitnik za veliki depresivni poremećaj, ali da može biti neprikladan za procenu simptoma depresije među zdravstvenim radnicima koji imaju nizak nivo depresije [28] . Zdravstveni radnici veliko opterećenje, intezitet i složenost posla, dugo radno vreme, stalnu izloženost akutnom i hroničnom stresu i psihičku napetost prihvataju kao nešto sasvim normalno, kao sastavni deo svoje profesije.…”

Rasch analysis of the Chinese version of the Clinically Useful Depression Outcome Scale in patients with major depressive disorder

“…In the IRT eld, Rasch model is a relatively simple model of and also has solid mathematical foundation. In recent years, the application of Rasch analysis in health outcome measures is becoming increasingly popular [19][20][21]. Nowadays, Rasch model is considered to be the standard for modern psychometric assessment of outcome scales [22].…”