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      Are comparisons of mental disorders between Chinese and German students possible? An examination of measurement invariance for the PHQ-15, PHQ-9 and GAD-7


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          The Patient Health Questionnaire (PHQ) is one of the most commonly used instruments to assess mental disorders. However, research on its cross-cultural measurement invariance is not yet sufficient. This study examined the measurement invariance of the Chinese and German versions of the PHQ’s somatic symptom severity scale (PHQ-15), depressive symptom severity scale (PHQ-9) and seven-item Generalized Anxiety Disorder (GAD-7) scale as a prerequisite for their use in cross-cultural comparisons.


          We used online data collected from groups of Chinese students in China ( n = 413) and German students in Germany ( n = 416). Separate measurement models for each group were examined using confirmatory factor analysis and measurement invariance testing was conducted to test the cross-cultural equivalence.


          Findings demonstrated that the PHQ-9 and GAD-7 had partial scalar measurement invariance, but the cross-cultural measurement invariance of the PHQ-15 could not be confirmed. Comparisons of latent means did not indicate differences in the levels of depression and anxiety symptoms between Chinese and German samples.


          The PHQ-9 and GAD-7 can be used in cross-cultural comparison of prevalence, but the intercultural use of PHQ-15 is more problematic. Findings are discussed from intercultural and methodological perspectives.

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          Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population.

          The aim of this study was to assess the validity of the Patient Health Questionnaire depression module (PHQ-9). It has been subject to studies in medical settings, but its validity as a screening for depression in the general population is unknown. A representative population sample (2,066 subjects, 14-93 years) filled in the PHQ-9 for diagnosis [major depressive disorder, other depressive disorder, depression screen-positive (DS+) and depression screen-negative (DS-)] and other measures for distress (GHQ-12), depression (Brief-BDI) and subjective health perception (EuroQOL; SF-36). A prevalence rate of 9.2% of a current PHQ depressive disorder (major depression 3.8%, subthreshold other depressive disorder 5.4%) was identified. The two depression groups had higher Brief-BDI and GHQ-12 scores, and reported lower health status (EuroQOL) and health-related quality of life (SF-36) than did the DS- group (P's < .001). Strong associations between PHQ-9 depression severity and convergent variables were found (with BDI r = .73, with GHQ-12 r = .59). The results support the construct validity of the PHQ depression scale, which seems to be a useful tool to recognize not only major depression but also subthreshold depressive disorder in the general population.
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            Exploratory Structural Equation Modeling, Integrating CFA and EFA: Application to Students' Evaluations of University Teaching

              • Record: found
              • Abstract: not found
              • Article: not found

              Screening psychischer Störungen mit dem “Gesundheitsfragebogen für Patienten (PHQ-D)“


                Author and article information

                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1 October 2020
                1 October 2020
                : 20
                [1 ]GRID grid.10253.35, ISNI 0000 0004 1936 9756, Clinical Psychology and Psychotherapy, Department of Psychology, , Philipps-University of Marburg, ; Gutenbergstr. 18, D-35032 Marburg, Germany
                [2 ]GRID grid.207374.5, ISNI 0000 0001 2189 3846, Department of Marxism, , University of Zhengzhou, ; Zhengzhou, China
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                : 22 April 2020
                : 8 September 2020
                Research Article
                Custom metadata
                © The Author(s) 2020

                Clinical Psychology & Psychiatry
                cross-cultural comparison,measurement invariance,patient health questionnaire-15 (phq-15),patient health questionnaire-9 (phq-9),generalized anxiety disorder-7 (gad-7)


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