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PM R. 2011 Jun;3(6):533-40; quiz 540. doi: 10.1016/j.pmrj.2011.03.003.

Confirmatory factor analysis of the Patient Health Questionnaire-9: a study of the participants from the spinal cord injury model systems.

Author information

  • 1Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, 77 President St, C101, MSC 700, Charleston, SC 29425, USA. krause@musc.edu

Abstract

OBJECTIVE:

To examine the factor structure of the Patient Health Questionnaire-9, a measure of depression, in persons with spinal cord injury (SCI).

DESIGN:

Cross-sectional, confirmatory factor analytic study.

SETTING:

Community.

PARTICIPANTS:

Data for 7296 persons with an SCI who had sustained their injury at least 1 year prior to assessment and who had complete Patient Health Questionnaire-9 data collected at a follow-up interview were drawn from the National Spinal Cord Injury Statistical Center Database.

INTERVENTIONS:

None.

MAIN OUTCOME MEASURES:

Factor structure of the Patient Health Questionnaire-9.

RESULTS:

Confirmatory factor analysis indicated a marginal fit for the single factor solution (root mean square error of approximation [RMSEA] = 0.086), whereas the solution with 5 somatic items and 4 nonsomatic items had the best fit (RMSEA = 0.054) among 2-factor models that used all 9 items. Of the models that used fewer than 9 items, the best fit was for the 6-item solution with 3 somatic items (sleep, appetite, and fatigue) and 3 nonsomatic items (feeling down, feeling bad about self, and suicidal ideation; RMSEA = 0.043). Similar results were found across the strata except for the Hispanic group (for whom no model fit well).

CONCLUSIONS:

Given the results of this analysis that support a 2-factor structure of the Patient Health Questionnaire-9 in persons with SCI, the next step in this line of research is to validate each of these dimensions against other ways of measuring depression.

Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

PMID:
21665166
[PubMed - indexed for MEDLINE]
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