Validation of the Arabic Version of Patient Health Questionnaire‐9 in Omani and Yemeni Patients With Chronic Physical Diseases
Amira Mohammed Ali, Saeed A. Al‐Dossary, Carlos Laranjeira, Sameer A. Alkubati, Maryam Alharrasi, Heba Emad El‐Gazar, Shawana Masad Al Harrasi, Rasmieh Alamer, Mohamed Ali Zoromba, Ahmad M. A. Zayed, Abdalla S. M. Gaballa, Annamaria Pakai, Murat Yıldırım, Ahmad H. Abu Raddaha, Haitham KhatatbehABSTRACT
Background
Secondary depression frequently develops in people with chronic diseases, and it may hinder disease progress and treatment outcomes. This study aimed to examine the construct validity and measurement invariance of the Arabic version of the Patient Health Questionnaire‐9 (PHQ‐9) among patients with chronic physical conditions.
Methods
This cross‐sectional study used confirmatory factor analysis (CFA) and multigroup CFA to evaluate the Arabic PHQ‐9 in a convenience sample comprising patients with cancer, heart failure (HF), and renal failure (RF) from Oman and Yemen.
Results
Out of eight models, the unidimensional PHQ‐9 (depression) displayed satisfactory fit when three pairs of error were correlated whereas a similar fit was exhibited by a three‐factor (somatic, cognitive/affective, and concentration/motor) solution, which was modified into (somatic, affective, and cognitive–psychomotor) solution based on partial scalar analysis tests. This structure was invariant across all sociodemographic characteristics, with better values of reliability coefficients, average variance extracted, and heterotrait‐monotrait ratios of correlation.
Conclusion
The Arabic PHQ‐9 is a reliable and psychometrically stable tool that may differentiate depressive symptoms in people with chronic disorders into three symptom groups. Meaningful comparisons between countries support higher psychological burden of physical disorders in Yemen than Oman.