Depression and Anxiety
Volume 35, Issue 12, 2018, Pages 1178-1189

Is assessment of depression equivalent for migrants of different cultural backgrounds? Results from the German population-based Gutenberg Health Study (GHS) (Article)

Tibubos A.N.* , Beutel M.E. , Schulz A. , Klein E.M. , Brähler E. , Michal M. , Münzel T. , Wild P.S. , Lackner K. , König J. , Pfeiffer N. , Wiltink J.
  • a Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • b Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • c Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • d Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • e Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • f Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • g Center for Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, DZHK (German Center for Cardiovascular Research), Mainz, Germany, Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • h Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, DZHK (German Center for Cardiovascular Research), Mainz, Germany, Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • i Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • j Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • k Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • l Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany

Abstract

Background: Bearing in mind the multicultural background of a national population, little is known about the measurement invariance across different cultures or ethnicities of frequently used screeners for depression. For this reason, the main objective of the current study is to assess the measurement invariance of the Patient Health Questionnaire (PHQ-9) across groups with different migration backgrounds. Methods: We provided psychometric analyses (descriptive statistics at item and scale level, reliability analysis, exploratory [EFA] and confirmatory factor analyses [CFA]) comparing a native population with first- and second-generation migrants of the German population-based Gutenberg Health Study with N = 13,973 participants completing the PHQ-9. Furthermore, we conducted measurement invariance analyses among different groups of first-generation migrants. Results: Comparing the native population with first- and second-generation migrants, a higher prevalence for mental distress was found for first generation. Although mean score patterns were similar for all groups, analyses of item loadings among first-generation migrants yielded some variance in patterns pointing out that certain items have a distinct impact on depression for specific groups. With regard to the factorial validity for all groups, EFA and CFA provided evidence for the proposed one latent factor structure of the PHQ-9. Depression assessed by the PHQ-9 turned out to be equivalent from a psychometric perspective across different groups stratified by their migration background. Conclusions: Overall, results of thorough scale and item analyses, especially multigroup confirmatory analyses, provided support that depression, assessed by the PHQ-9, can be considered as psychometrically equivalent across all analyzed groups. © 2018 Wiley Periodicals, Inc.

Author Keywords

crossnational measurement/psychometrics Depression Epidemiology assessment/diagnosis

Index Keywords

cultural anthropology Germany depression human middle aged statistics and numerical data controlled study priority journal Aged Depressive Disorder ethnology cross-sectional study migrant Humans male Emigrants and Immigrants female Germanic people exploratory factor analysis confirmatory factor analysis reproducibility observational study Reproducibility of Results diagnostic test accuracy study cultural factor population research Patient Health Questionnaire 9 prevalence patient health questionnaire standards Article sensitivity and specificity psychometry adult migration distress syndrome cohort analysis Culture
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85052788853&doi=10.1002%2fda.22831&partnerID=40&md5=1d460d19b65a55446f6d3ee71bf9b545
DOI: 10.1002/da.22831
ISSN: 10914269
Original Language: English