The Patient Health Questionnaire-9 among First-Trimester Pregnant Women in Japan: Factor Structure and Measurement and Structural Invariance between Nulliparas and Multiparas and across Perinatal Measurement Time Points

摘要

Background:? Depression is frequently seen among pregnant women. ?The ?PHQ-9 is a diagnostic criteria-based screening instrument.? Objective:? T he objective is to ?identify the factor structure?of the Patient Health Questionnaire-9 (PHQ-9) and to confirm its measurement and structural invariance regarding parity and observation time, as well as to examine reliability by calculating omega indices ? in a population of pregnant Japanese women. ? Methods: ?The PHQ-9 was distributed to 382 pregnant women with a gestational age of 10 to 13 weeks who were attending antenatal clinics. Of these women,? 129 ?were tested again with the PHQ-9 one week later. ? Results: ?Exploratory factor analyses (EFAs) of the PHQ-9 items were conducted using a halved sample. Confirmatory factor analyses (CFAs) among the other halved sample compared the single-, two-factor models derived from the EFAs, literature model and bifactor model. The bif a ctor model was significantly better in terms of goodness-of-fit indices:? χ ~( 2 ) / df ?= 1.030 (18), CFI = ?0 .999, RMSEA = 0.012. ECV suggested multidimensionality. Internal consistency was excellent:? ω ?= 0.868, ? ω . ? Somatic factor = 0.756, ? ω . ? Non-somatic factor = 0.817.? ω _( H ) ?= 0.795,? ω _( HS ) . ? Somatic factor = 0.330,? ω _( HS ) . ? Non-somatic factor = 0.032. The bifactor structure model showed configural, measurement, and structural invariances between primiparas and multiparas as well as at two observation occasions. ? Conclusion: ?The findings suggested that the PHQ-9 used among pregnant women was robust in its factor structure.