The factor structure of the Patient Health Questionnaire-9 in stroke: A comparison with a non-stroke population

Blake, J. J., Munyombwe, T., Fischer, F., Quinn, T. J., Van der Feltz-Cornelis, C. M., De Man-van Ginkel, J. M., Santos, I. S., Jeon, Hong Jin, Köhler, S., Schram, M. T., Wang, J. L., Levin-Aspenson, H. F., Whooley, M. A., Hobfoll, S. E., Patten, S. B., Simning, A., Gracey, F. ORCID: https://orcid.org/0000-0002-1416-7894 and Broomfield, N. M. ORCID: https://orcid.org/0000-0003-2599-3435 (2024) The factor structure of the Patient Health Questionnaire-9 in stroke: A comparison with a non-stroke population. Journal of Psychosomatic Research. ISSN 0022-3999

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Abstract

Background: It is unclear if certain post-stroke somatic symptoms load onto items of the Patient Health Questionnaire-9 (PHQ-9), a self-report depression questionnaire. We investigated these concerns in a stroke sample using factor analysis, benchmarked against a non-stroke comparison group. Methods: The secondary dataset constituted 787 stroke and 12,016 non-stroke participants. A subsample of 1574 comparison participants was selected via propensity score matching. Dimensionality was assessed by comparing fit statistics of one-factor, two-factor, and bi-factor models. Between-group differences in factor structure were explored using measurement invariance. Results: A two-factor model, consisting of somatic and cognitive-affect factors showed better fit than a unidimensional model (CFI = 0.984 versus CFI = 0.974, p  Conclusions: The findings suggest that the PHQ-9 measures a single factor in stroke. Because stroke patients may report higher tiredness on item 4, caution in classifying patients as depressed who are near the cut-off is advisable for those with significant post-stroke fatigue. Caution is also advised when comparing total scores between stroke and other populations.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Depositing User:	LivePure Connector
Date Deposited:	21 Nov 2024 11:30
Last Modified:	21 Nov 2024 12:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97743
DOI:	10.1016/j.jpsychores.2024.111983

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