Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic

M Shevlin; Sarah Butter; Orla McBride; Jamie Murphy; Jilly Gibson‐Miller; Todd K. Hartman; Liat Levita; Liam Mason; Anton P. Martinez; Ryan McKay; Thomas VA Stocks; Kate M. Bennett; Philip Hyland; Frédérique Vallieres; Carmen Valiente; Carmelo Vazquez; Alba Contreras; Vanesa  Peinado; Almudena  Trucharte; Marco Bertamini; Anna Panzeri; Giovanni Bruno; Umberto  Granziol; Giuseppe  Mignemi; Andrea  Spoto; Giulio  Vidotto; Richard P. Bentall

doi:10.1186/s12888-022-03787-5

Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic

M Shevlin, Sarah Butter, Orla McBride, Jamie Murphy, Jilly Gibson‐Miller, Todd K. Hartman, Liat Levita, Liam Mason, Anton P. Martinez, Ryan McKay, Thomas VA Stocks, Kate M. Bennett, Philip Hyland, Frédérique Vallieres, Carmen Valiente, Carmelo Vazquez, Alba Contreras, Vanesa Peinado, Almudena Trucharte, Marco BertaminiAnna Panzeri, Giovanni Bruno, Umberto Granziol, Giuseppe Mignemi, Andrea Spoto, Giulio Vidotto, Richard P. Bentall

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Abstract

Background: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country.
Method: Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models.
Results: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning.
Conclusions: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

Original language	English
Article number	154
Journal	BMC Psychiatry
Volume	22
Issue number	1
Early online date	1 Mar 2022
DOIs	https://doi.org/10.1186/s12888-022-03787-5
Publication status	Published online - 1 Mar 2022

Bibliographical note

Funding Information:
Ireland: The Irish strand of this study was funded by the Health Research Board and the Irish Research Council under the COVID-19 Pandemic Rapid Response Funding Call [COV19-2020-025] awarded to PH.

Funding Information:
UK: The initial stages of this project were supported by start-up funds from the University of Sheffield (Department of Psychology, the Sheffield Methods Institute and the Higher Education Innovation Fund via an Impact Acceleration grant administered by the university) and by the Faculty of Life and Health Sciences at Ulster University. The research was subsequently supported by UK Research and Innovation/Economic and Social Research Council funding (grant ref. ES/V004379/1) and awarded to RPB, TKH, LL, JGM, MS, JM, OM, KB and LM.

Funding Information:
Spain: This research was supported by grants from the Ministry of Science and Innovation (PSI2016-74987-P) and Instituto de Salud Carlos III (COV20/00737) to Carmen Valiente and funds from the UCM for consolidated research groups (GR29/20) to Carmelo Vazquez.

Funding Information:
Italy: This research was funded by the University “La Sapienza” of Roma and the Department of General Psychology of the University of Padua.

Publisher Copyright:
© 2022, The Author(s).

Keywords

Anxiety
Depression
GAD-7
Measurement invariance
PHQ-9
Pandemics
Patient Health Questionnaire
Humans
Male
Psychometrics
SARS-CoV-2
COVID-19/epidemiology
Female
Surveys and Questionnaires
Depressive Disorder, Major/diagnosis
Measurement Invariance
Gad-7
COVID-19
Depressive Disorder, Major
Phq-9

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Shevlin, M., Butter, S., McBride, O., Murphy, J., Gibson‐Miller, J., Hartman, T. K., Levita, L., Mason, L., Martinez, A. P., McKay, R., Stocks, T. VA., Bennett, K. M., Hyland, P., Vallieres, F., Valiente, C., Vazquez, C., Contreras, A., Peinado, V., Trucharte, A., ... Bentall, R. P. (2022). Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic. BMC Psychiatry, 22(1), Article 154. Advance online publication. https://doi.org/10.1186/s12888-022-03787-5

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title = "Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic",

abstract = "Background: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country.Method: Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models.Results: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning.Conclusions: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.",

keywords = "Anxiety, Depression, GAD-7, Measurement invariance, PHQ-9, Pandemics, Patient Health Questionnaire, Humans, Male, Psychometrics, SARS-CoV-2, COVID-19/epidemiology, Female, Surveys and Questionnaires, Depressive Disorder, Major/diagnosis, Measurement Invariance, Gad-7, COVID-19, Depressive Disorder, Major, Phq-9",

author = "M Shevlin and Sarah Butter and Orla McBride and Jamie Murphy and Jilly Gibson‐Miller and Hartman, {Todd K.} and Liat Levita and Liam Mason and Martinez, {Anton P.} and Ryan McKay and Stocks, {Thomas VA} and Bennett, {Kate M.} and Philip Hyland and Fr{\'e}d{\'e}rique Vallieres and Carmen Valiente and Carmelo Vazquez and Alba Contreras and Vanesa Peinado and Almudena Trucharte and Marco Bertamini and Anna Panzeri and Giovanni Bruno and Umberto Granziol and Giuseppe Mignemi and Andrea Spoto and Giulio Vidotto and Bentall, {Richard P.}",

note = "Funding Information: Ireland: The Irish strand of this study was funded by the Health Research Board and the Irish Research Council under the COVID-19 Pandemic Rapid Response Funding Call [COV19-2020-025] awarded to PH. Funding Information: UK: The initial stages of this project were supported by start-up funds from the University of Sheffield (Department of Psychology, the Sheffield Methods Institute and the Higher Education Innovation Fund via an Impact Acceleration grant administered by the university) and by the Faculty of Life and Health Sciences at Ulster University. The research was subsequently supported by UK Research and Innovation/Economic and Social Research Council funding (grant ref. ES/V004379/1) and awarded to RPB, TKH, LL, JGM, MS, JM, OM, KB and LM. Funding Information: Spain: This research was supported by grants from the Ministry of Science and Innovation (PSI2016-74987-P) and Instituto de Salud Carlos III (COV20/00737) to Carmen Valiente and funds from the UCM for consolidated research groups (GR29/20) to Carmelo Vazquez. Funding Information: Italy: This research was funded by the University “La Sapienza” of Roma and the Department of General Psychology of the University of Padua. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

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Shevlin, M , Butter, S, McBride, O, Murphy, J, Gibson‐Miller, J, Hartman, TK, Levita, L, Mason, L, Martinez, AP, McKay, R, Stocks, TVA, Bennett, KM, Hyland, P, Vallieres, F, Valiente, C, Vazquez, C, Contreras, A, Peinado, V, Trucharte, A, Bertamini, M, Panzeri, A, Bruno, G, Granziol, U, Mignemi, G, Spoto, A, Vidotto, G & Bentall, RP 2022, 'Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic', BMC Psychiatry, vol. 22, no. 1, 154. https://doi.org/10.1186/s12888-022-03787-5

TY - JOUR

T1 - Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic

AU - Shevlin, M

AU - Butter, Sarah

AU - McBride, Orla

AU - Murphy, Jamie

AU - Gibson‐Miller, Jilly

AU - Hartman, Todd K.

AU - Levita, Liat

AU - Mason, Liam

AU - Martinez, Anton P.

AU - McKay, Ryan

AU - Stocks, Thomas VA

AU - Bennett, Kate M.

AU - Hyland, Philip

AU - Vallieres, Frédérique

AU - Valiente, Carmen

AU - Vazquez, Carmelo

AU - Contreras, Alba

AU - Peinado, Vanesa

AU - Trucharte, Almudena

AU - Bertamini, Marco

AU - Panzeri, Anna

AU - Bruno, Giovanni

AU - Granziol, Umberto

AU - Mignemi, Giuseppe

AU - Spoto, Andrea

AU - Vidotto, Giulio

AU - Bentall, Richard P.

N1 - Funding Information: Ireland: The Irish strand of this study was funded by the Health Research Board and the Irish Research Council under the COVID-19 Pandemic Rapid Response Funding Call [COV19-2020-025] awarded to PH. Funding Information: UK: The initial stages of this project were supported by start-up funds from the University of Sheffield (Department of Psychology, the Sheffield Methods Institute and the Higher Education Innovation Fund via an Impact Acceleration grant administered by the university) and by the Faculty of Life and Health Sciences at Ulster University. The research was subsequently supported by UK Research and Innovation/Economic and Social Research Council funding (grant ref. ES/V004379/1) and awarded to RPB, TKH, LL, JGM, MS, JM, OM, KB and LM. Funding Information: Spain: This research was supported by grants from the Ministry of Science and Innovation (PSI2016-74987-P) and Instituto de Salud Carlos III (COV20/00737) to Carmen Valiente and funds from the UCM for consolidated research groups (GR29/20) to Carmelo Vazquez. Funding Information: Italy: This research was funded by the University “La Sapienza” of Roma and the Department of General Psychology of the University of Padua. Publisher Copyright: © 2022, The Author(s).

PY - 2022/3/1

Y1 - 2022/3/1

N2 - Background: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country.Method: Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models.Results: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning.Conclusions: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

AB - Background: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country.Method: Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models.Results: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning.Conclusions: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

KW - Anxiety

KW - Depression

KW - GAD-7

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KW - PHQ-9

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KW - Patient Health Questionnaire

KW - Humans

KW - Male

KW - Psychometrics

KW - SARS-CoV-2

KW - COVID-19/epidemiology

KW - Female

KW - Surveys and Questionnaires

KW - Depressive Disorder, Major/diagnosis

KW - Measurement Invariance

KW - Gad-7

KW - COVID-19

KW - Depressive Disorder, Major

KW - Phq-9

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DO - 10.1186/s12888-022-03787-5

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