Depressive symptomatology in adolescents in Ghana: Examination of psychometric properties of the Patient Health Questionnaire-9

Abstract

Background: The Patient Health Questionnaire (PHQ-9) has been used extensively in research and clinical settings. However, there is limited information regarding the psychometric properties of the PHQ-9 among adolescents, particularly in sub-Saharan Africa. Methods: Data were collected from 553 adolescents (girls = 322, 58.1%) using a cross-sectional survey design to investigate the factorial validity, construct validity and internal consistency of the PHQ-9 in Ghana. Results: Confirmatory factor analysis (CFA) and multi-group CFA support a one-factor structure of the PHQ-9 that was invariant across gender. The PHQ-9 correlates significantly with measures of anxiety, depression, mental wellbeing, and suicidal behavior. The internal consistency of the PHQ-9 was 0.71. Limitation: The study did not include a gold standard measure of depression to assess the diagnostic properties (e.g., sensitivity and specificity) of the PHQ-9. Conclusion: The results suggest that major depressive disorder, measured by the PHQ-9, is a homogeneous construct across gender and that the PHQ-9 can be used to screen for depressive symptoms in adolescent boys and girls in Ghana. © 2019 Elsevier B.V.