Blake, J. J. ORCID: https://orcid.org/0000-0002-4105-3825, 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 (2025) The factor structure of the Patient Health Questionnaire-9 in stroke: A comparison with a non-stroke population. Journal of Psychosomatic Research, 188. 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 |
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Additional Information: | Data access statement: We are unable to share the data publicly. Funding statement: None received. |
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: | 02 Dec 2024 01:45 |
URI: | https://ueaeprints.uea.ac.uk/id/eprint/97743 |
DOI: | 10.1016/j.jpsychores.2024.111983 |
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