The structure of the Patient Health Questionnaire-9 in pregnant women in Spain

Objective: To evaluate psychometric properties and the factor structure of the Spanish version of the Patient Health Questionnaire (PHQ-9) in pregnant women received care in an urban public hospital in Span. Research design/setting: In a cross-sectional study, the reliability and factor structure were examined. Exploratory and confirmatory factor analyses were conducted to examine the latent structure of the PHQ-9 with a pregnant Spanish-speaking sample (n = 445) recruited during the first trimester in an obstetrics clinic in Madrid. Measurements and findings: The Spanish version of PHQ-9 had moderate internal consistency (alpha = 0.81). Exploratory factor analysis revealed a two-factor (cognitive-affective, somatic) and three-factor (cognitive-affective, somatic, pregnancy-related) structure of the PHQ-9, whereas confirmatory factor analyses support a three-factor model (cognitive-affective, somatic, pregnancy-related) as the best fit to the data. Key Conclusions: The Spanish version of PHQ-9 is reliable and can be used to screen for depression during pregnancy. A three-factor model structure is adequate to evaluate the components and symptoms of depression for Spanish pregnant women. Implication for practice: Midwives can screen for depression during the PHQ-9 and can tailor interventions to minimize the adverse effects on mothers and infants, before and after birth.