Translating measurement into practice: Brazilian norms for depressive symptom assessment with the Patient Health Questionnaire (PHQ-9)

Damiano, Rodolfo Furlan, Hoffmann, Mauricio Scopel, Gosmann, Natan Pereira, Pan, Pedro Mario, Miguel, Eurípedes Constantino and Salum, Giovanni Abrahão (2023) Translating measurement into practice: Brazilian norms for depressive symptom assessment with the Patient Health Questionnaire (PHQ-9). Brazilian Journal of Psychiatry, 45 (4). 310 - 317. ISSN 1516-4446

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Abstract

OBJECTIVES: To provide practical norms for measuring depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9) in Brazil through a state-of-the-art psychometrics analysis. METHODS: We used a large representative dataset from the 2019 Brazilian National Health Survey (Pesquisa Nacional de Saúde - 2019), which included 90,846 Brazilian citizens. To assess scale structure, we assessed a unidimensional model using confirmatory factor analysis. Item response theory was used to characterize the distribution of depressive symptoms. Summed- and mean-based PHQ-9 scores were then linked using item response theory-based scores in generalized additive models. Finally, percentiles, T scores, and a newly developed score, called the decimal score (D score), were generated to describe PHQ-9 norms for the Brazilian population. RESULTS: Confirmatory factor analysis revealed a good fit to the unidimensional model, being invariant to age and sex. Item response theory captured item-level information about the latent trait (reliable from 1 to 3 SDs above the mean). Brazilian norms were presented using summed scores, T scores, and D scores. CONCLUSION: This is the first study to determine Brazilian norms for the PHQ-9 among a large representative sample using robust psychometric tools. More precise PHQ-9 scores are now available and may be widely used in primary and specialized clinical care settings.

Item Type:	Article
Official URL:	https://www.bjp.org.br/
Additional Information:	© 2023 The Authors
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RA Public aspects of medicine
Date Deposited:	14 Nov 2023 10:21
Last Modified:	03 Dec 2024 02:30
URI:	http://eprints.lse.ac.uk/id/eprint/120733

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