Depressive symptomatology in adolescents in Ghana: Examination of psychometric properties of the Patient Health Questionnaire-9

Anum, Adote; Adjorlolo, Samuel; Kugbey, Nuworza

doi:10.1016/j.jad.2019.06.007

Cited by 41 publications

(31 citation statements)

References 34 publications

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“…Stigma was measured using a truncated (10 question) Berger HIV Stigma Scale. Included questions related to both internal or 'negative self-image' (four questions, 2,3, 7,12) and external stigma or 'public attitudes' (six questions, 9,10,14,16,20,32) and were analyzed in these two categories as well as the total score for interpreting results (scale range 10-40) [40] and were used in our prior research [9].…”

Section: Methodsmentioning

confidence: 99%

“…The Patient Health Questionnaire (PHQ-9) was used to measure symptoms of depression. The PHQ-9 has been validated relative to other diagnostic tools in several studies in Africa, [ 30 , 31 ] including adolescent populations in Kenya and Ghana [ 32 , 33 ] demonstrating high internal consistency with Chronbach alphas of > 0.70 [ 32 , 34 ]. This measure includes nine questions with a response range of 0–27 with a score of 10 or greater used as a screening threshold suggestive of moderate to severe depressive symptoms [ 30 , 31 ] and was used in our prior research [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

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A group-based mental health intervention for young people living with HIV in Tanzania: results of a pilot individually randomized group treatment trial

et al. 2020

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Background: Increasing numbers of young people living with HIV (YPLWH) have unaddressed mental health challenges. Such challenges are associated with poor antiretroviral therapy (ART) adherence and high mortality. Few evidence-based mental health interventions exist to improve HIV outcomes among YPLWH. Methods: This pilot group treatment trial individually randomized YPLWH from two clinical sites in Tanzania, evaluated acceptability, feasibility, and preliminary effectiveness of a mental health intervention, Sauti ya Vijana (SYV; The Voice of Youth), was compared to the local standard-of-care (SOC) for improving ART adherence and virologic suppression. Enrolled YPLWH were 12-24 years of age and responded to mental health and stigma questionnaires, self-reported adherence, objective adherence measures (ART concentration in hair), and HIV RNA at baseline and 6-months (post-intervention). Feasibility and acceptability were evaluated, and potential effectiveness was assessed by comparing outcomes between arms using mixed effects modeling. Results: Between June 2016 and July 2017, 128 YPLWH enrolled; 105 were randomized and 93 (55 in SYV) followedup at 6-months and were thereby included in this analysis. Mean age was 18.1 years; 51% were female; and 84% were HIV-infected perinatally. Attendance to intervention sessions was 86%; 6-month follow-up was 88%, and fidelity to the protocol approached 100%. Exploratory analyses of effectiveness demonstrated self-reported adherence improved by 7.3 percentage points (95% CI: 2.2, 12.3); and the pooled standard deviation for all ART concentration values increased by 0.17 units (95% CI: − 0.52, 0.85) in the SYV arm compared to SOC. Virologic suppression rates (HIV RNA < 400 copies/ mL) at baseline were 65% in both arms but increased to 75% in the SYV arm while staying the same in the SOC arm (RR 1.13; 95% CI: 0.94, 1.36).

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A group-based mental health intervention for young people living with HIV in Tanzania: results of a pilot individually randomized group treatment trial

et al. 2020

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“…The psychometric properties of the PHQ-9 have been evaluated with various population, including psychiatric patients [16,17], specific groups of medical patients [18-21], the general adult population [22,23], multicultural populations [24-27], the elderly [24], university students [13,25,26], and adolescents [27]. Although the internal consistency of the PHQ-9 has proved to be adequate (α=0.70–0.93) [13,16-27] and the results have indicated moderate to strong associations with related measures of depression and anxiety, analyses of the underlying factor structure of the PHQ-9 have been generally inconsistent. For example, several studies have suggested that a one-factor model reflecting unidimensionality of the depression construct provided the best fit to the data among primary care patients [14], U.S. and Nigerian college samples [13,25], general adults in Hong Kong and Germany [22,23], and adolescents in Ghana [27].…”

Section: Introductionmentioning

confidence: 99%

“…Although the internal consistency of the PHQ-9 has proved to be adequate (α=0.70–0.93) [13,16-27] and the results have indicated moderate to strong associations with related measures of depression and anxiety, analyses of the underlying factor structure of the PHQ-9 have been generally inconsistent. For example, several studies have suggested that a one-factor model reflecting unidimensionality of the depression construct provided the best fit to the data among primary care patients [14], U.S. and Nigerian college samples [13,25], general adults in Hong Kong and Germany [22,23], and adolescents in Ghana [27]. However, other studies in primary care settings with psychiatric patients [16,17], patients with coronary heart disease [18], traumatic spinal cord injury patients [19-21], elderly psychiatric patients in Taiwan [24], and female Latina university students [26] found that two-factor models distinguishing somatic and non-somatic domains best represented the PHQ-9 factor structure.…”

Section: Introductionmentioning

confidence: 99%

The Psychometric Properties of the Patient Health Questionnaire-9 in a Sample of Korean University Students

Kim

Lee

2019

Psychiatry Investig

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In South Korea (hereafter Korea), mental-health problems have become an important national issue. Korea's public health authority has focused heavily on mental health, particularly depression, due to the country's consistently high suicide rate relative to other Organization for Economic Cooperation and Development (OECD) member nations. 5 In fact, Korea has had the highest suicide rate among OECD countries in annual rankings more than 10 times since 2003. 6 Korea's suicide rate of 29.1 per 100,000 people in 2015 was up to five times higher than the rate in other OECD countries. 6 Suicide has been the leading cause of death for Koreans in their twenties and thirties, according to the National Statistical Office of Korea. 7 Presumably, depression plays a prominent role in many of these suicides. In Korea, the diagnosed prevalence rate for depression was 3% in 2016, with slightly greater prevalence among men (3.1%) than among women (2.9%) in the 18-29 age bracket. 8 Entering university can be a highly stressful life transition for many or even most students, bringing with it increased exposure to stressors. During this crucial stage, students commonly experience financial stress, academic demands, fear of

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“…Although the PHQ-9 is a widely validated tool, the current study is among the first to apply a bifactor analysis to test its structure in the African context. In spite of the recent increase in the use of the PHQ-9 in epidemiological surveillance in Ghana, only one study [ 72 ] has examined the psychometric properties of the original English version of the PHQ-9 among a sample of Senior High School students in Ghana. The recent advocacy for the integration of mental health into primary health care to allow for comprehensive assessment and treatment of mental disorders, particularly in LAMIC [ 73 ], necessitates valid and reliable measures that are also culturally sensitive and has the ability to detect the presence of mental illness in nonclinical populations.…”

Section: Resultsmentioning

confidence: 99%

Factorial validity of the Twi versions of five measures of mental health and well-being in Ghana

et al. 2020

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Background Mental health is considered an integral part of human health. Reliable and valid measurement instruments are needed to assess various facets of mental health in the native language of the people involved. This paper reports on five studies examining evidence for the factorial validity of the Twi versions of five mental health and well-being measurement instruments: Affectometer-2 (AFM-2); Automatic Thought Questionnaire–Positive (ATQ-P); Generalized Self-Efficacy Scale (GSEs); Patient Health Questionnaire-9 (PHQ-9); and Satisfaction with Life Scale (SWLS) in a rural Ghanaian adult sample. Method Measures were translated and evaluated using a research-committee approach, pilot-tested, and administered to adults ( N = 444) randomly selected from four rural poor communities in Ghana. We applied confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM to the AFM-2, ATQ-P, and the PHQ-9, and CFA to the GSEs and the SWLS. The omega coefficient of composite reliability was computed for each measure. Results A two-factor bifactor ESEM model displayed superior model fit for the AFM-2. The total scale and the Negative Affect subscale, but not the Positive Affect subscale, attained sufficient reliability. Two models (a four-factor 22-item bifactor ESEM model and a 5-factor 22-item ESEM model) fitted the data best for the ATQ-P. The bifactor ESEM model displayed a high reliability value for the total scale and satisfactory reliability values for three of its four subscales. For the GSEs, a one-factor CFA model (residuals of items 4 and 5 correlated) demonstrated superior model fit with a high reliability score for the total scale. A two-factor ESEM model outperformed all other models fitted for the PHQ-9, with moderate and satisfactory reliability scores for the subscales. A one-factor CFA model (residuals of item 4 and 5 correlated) demonstrated superior model fit for the SWLS, with a satisfactory reliability value for the total scale. Conclusions Findings established evidence for the factorial validity of the Twi versions of all five measures, with the global scores, but not all subscale scores, demonstrating satisfactory reliability. These validated measurement instruments can be used to assess mental health and well-being in the research and practice contexts of the current sample.

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Depressive symptomatology in adolescents in Ghana: Examination of psychometric properties of the Patient Health Questionnaire-9

Cited by 41 publications

References 34 publications

A group-based mental health intervention for young people living with HIV in Tanzania: results of a pilot individually randomized group treatment trial

A group-based mental health intervention for young people living with HIV in Tanzania: results of a pilot individually randomized group treatment trial

The Psychometric Properties of the Patient Health Questionnaire-9 in a Sample of Korean University Students

Factorial validity of the Twi versions of five measures of mental health and well-being in Ghana

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