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. 2024 Apr 30;24(1):331.
doi: 10.1186/s12888-024-05783-3.

A Chinese adaptation of the Patient Health Questionnaire for Adolescents (PHQ-A): factor structure and psychometric properties

Yu-Qi Chen  1   2 , Xiao-Jie Huang  2 , Fan Yang  2 , Jing-Jing Yang  2 , Jing Zhong  1   2 , Kai-Min Yao  1   2 , Jing-Xiao Kuang  1   2 , Ming-Zhi Xu  3   4
Affiliations

A Chinese adaptation of the Patient Health Questionnaire for Adolescents (PHQ-A): factor structure and psychometric properties

Yu-Qi Chen et al. BMC Psychiatry. .

Abstract

Background: To examine the factor structure and psychometric properties of the Patient Health Questionnaire for Adolescents (PHQ-A) in Chinese children and adolescents with major depressive disorder (MDD).

Methods: A total of 248 MDD patients aged between 12 and 18 years were recruited and evaluated by the Patient Health Questionnaire for Adolescents (PHQ-A), the Center for Epidemiological Survey Depression Scale (CES-D), the Mood and Feelings Questionnaire (MFQ), and the improved Clinical Global Impression Scale, Severity item (iCGI-S). Thirty-one patients were selected randomly to complete the PHQ-A again one week later. Confirmatory factor analysis (CFA) was used to test the construct validity of the scale. Reliability was evaluated by Macdonald Omega coefficient. Pearson correlation coefficient was used to assess the item-total correlation and the correlation of PHQ-A with CES-D and MFQ respectively. Spearman correlation coefficient was used to assess test-retest reliability. The optimal cut-off value, sensitivity, and specificity of the PHQ-A were achieved by estimating the Receiver Operating Characteristics (ROC) curve.

Results: CFA reported adequate loadings for all items, except for item 3. Macdonald Omega coefficient of the PHQ-A was 0.87. The Spearman correlation coefficient of the test-retest reliability was 0.70. The Pearson correlation coefficients of the PHQ-A with CES-D and MFQ were 0.87 and 0.85, respectively (p < 0.01). By taking the iCGI-S as the remission criteria for MDD, the optimal cut-off value, sensitivity and specificity of the PHQ-A were 7, 98.7%, 94.7% respectively.

Conclusion: The PHQ-A presented as a unidimensional construct and demonstrated satisfactory reliability and validity among the Chinese children and adolescents with MDD. A cut-off value of 7 was suggested for remission.

Keywords: Adolescents; Cut-off value; Depression; Factor structure; PHQ-A; Psychometric properties.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Single-factor CFA analysis to the Chinese translation of the Patient Health Questionnaire for Adolescents (PHQ-A). (Note: b1 = item1 of the PHQ-A; b2 = item2; b3 = item3; b4 = item4; b5 = item5; b6 = item6; b7 = item7; b8 = item8; b9 = item9
Fig. 2
Fig. 2
The receiver operating characteristic (ROC) curve of the Chinese translation of the Patient Health Questionnaire for Adolescents (PHQ-A)
See this image and copyright information in PMC

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