期刊
BMC PSYCHIATRY
卷 21, 期 1, 页码 -出版社
BMC
DOI: 10.1186/s12888-021-03234-x
关键词
Depression; Somatic dimension; Cognitive-affective dimension; Sex-differences; Regional differences
类别
资金
- Federal Ministry of Education and Research (BMBF) [01GL1718A]
- government of Rhineland-Palatinate (Stiftung Rheinland-Pfalz fur Innovation) [AZ 961-386261/733]
- research program Wissen schafft Zukunft of the Johannes Gutenberg-University of Mainz
- research program Center for Translational Vascular Biology (CTVB) of the Johannes Gutenberg-University of Mainz
- Boehringer Ingelheim
- PHILIPS Medical Systems
- Federal Ministry of Education and Research [BMBF 01EO1503, 01ZZ9603, 01ZZ0103, 01ZZ0403]
- Helmholtz Zentrum Munchen - German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)
- State of Bavaria
- Ministry of Cultural Affairs
- Social Ministry of the Federal State of Mecklenburg-West Pomerania
- Projekt DEAL
- Federal Ministry of Education and Research
The PHQ-9 was found to have a bidimensional structure consisting of somatic and cognitive-affective dimensions. Women reported depressive symptoms, somatic, and cognitive-affective symptoms more frequently. A two-factor and bifactor model showed better fit compared to a one-factor model.
Background The Patient Health Questionnaire-9 (PHQ-9) has been proposed as a reliable and valid screening instrument for depressive symptoms with one latent factor. However, studies explicitly testing alternative model structures found support for a two-dimensional structure reflecting a somatic and a cognitive-affective dimension. We investigated the bidimensional structure of the PHQ-9, with a somatic (sleeping problems, fatigability, appetitive problems, and psychomotor retardation) and a cognitive-affective dimension (lack of interest, depressed mood, negative feelings about self, concentration problems, and suicidal ideation), and tested for sex- and regional-differences. Methods We have included data from the GEnder-Sensitive Analyses of mental health trajectories and implications for prevention: A multi-cohort consortium (GESA). Privacy-preserving analyses to provide information on the overall population and cohort-specific information and analyses of variance to compare depressive, somatic and cognitive-affective symptoms between sexes and cohorts were executed in DataSHIELD. In order to determine the dimensionality and measurement invariance of the PHQ-9 we tested three models (1 factor, 2 correlated factors, and bifactor) via confirmatory analyses and performed multi-group confirmatory factor analysis. Results Differences between sex and cohorts exist for PHQ-9 and for both of its dimensions. Women reported depressive symptoms in general as well as somatic and cognitive-affective symptoms more frequently. For all tested models an acceptable to excellent fit was found, consistently indicating a better model fit for the two-factor and bifactor model. Scalar measurement invariance was established between women and men, the three cohorts, and their interaction. Conclusions The two facets of depression should be taken into account when using PHQ-9, while data also render support to a general factor. Somatic and cognitive-affective symptoms assessed by the PHQ-9 can be considered equivalent across women and men and between different German populations from different regions.
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