Measurement Invariance Testing of the Patient Health Questionnaire-9 (PHQ-9) across People with and without Diabetes Mellitus from the NHANES, EHMS and UK Biobank datasets

Nouwen, Arie ORCID: https://orcid.org/0000-0002-0609-4082, Deschenes, Sonia, Balkhiyarova, Zhanna, Albertorio-Diaz, Juan, Prokopenko, Inga and Schmitz, Norbert (2021) Measurement Invariance Testing of the Patient Health Questionnaire-9 (PHQ-9) across People with and without Diabetes Mellitus from the NHANES, EHMS and UK Biobank datasets. Journal of Affective Disorders, 292 . pp. 311-318. ISSN 0165-0327 [Article] (Published online first) (doi:10.1016/j.jad.2021.05.031)

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Abstract

Background: The prevalence of depression is higher among those with diabetes than in the general population.
The Patient Health Questionnaire (PHQ-9) is commonly used to assess depression in people with diabetes, but
measurement invariance of the PHQ-9 across groups of people with and without diabetes has not yet been
investigated.

Methods: Data from three independent cohorts from the USA (n=1,886 with diabetes, n=4,153 without diabetes),
Quebec, Canada (n= 800 with diabetes, n= 2,411 without diabetes), and the UK (n=4,981 with diabetes,
n=145,570 without diabetes), were used to examine measurement invariance between adults with and without
diabetes. A series of multiple group confirmatory factor analyses were performed, with increasingly stringent
model constraints applied to assess configural, equal thresholds, and equal thresholds and loadings invariance,
respectively. One-factor and two-factor (somatic and cognitive-affective items) models were examined.

Results: Results demonstrated that the most stringent models, testing equal loadings and thresholds, had satisfactory
model fit in the three cohorts for one-factor models (RMSEA = .063 or below and CFI = .978 or above)
and two-factor models (RMSEA = .042 or below and CFI = .989 or above).

Limitations: Data were from Western countries only and we could not distinguish between type of diabetes.

Conclusions: Results provide support for measurement invariance between groups of people with and without
diabetes, using either a one-factor or a two-factor model. While the two-factor solution has a slightly better fit,
the one-factor solution is more parsimonious. Depending on research or clinical needs, both factor structures can
be used.

Item Type: Article
Research Areas: A. > School of Science and Technology > Psychology
Item ID: 33424
Notes on copyright: © 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Useful Links:
Depositing User: Arie Nouwen
Date Deposited: 18 Jun 2021 08:24
Last Modified: 18 Jun 2021 08:24
URI: https://eprints.mdx.ac.uk/id/eprint/33424

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