Line Wisting1, Sverre Urnes Johnson2,3, Cynthia M Bulik4,5,6, Ole A Andreassen7, Øyvind Rø8,9, Lasse Bang8. 1. Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424, Oslo, Norway. line.wisting@ous-hf.no. 2. Department of Psychology, University of Oslo, Oslo, Norway. 3. Modum Bad Psychiatric Center, Vikersund, Norway. 4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 5. Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 6. Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 7. NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway. 8. Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424, Oslo, Norway. 9. Faculty of Medicine, Mental Health and Addiction, University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: Internationally, the Patient Health Questionnaire-9 (PHQ-9) is commonly used to assess the frequency and severity of depressive symptoms. However, psychometric properties of the Norwegian version of the PHQ-9 have only been assessed in adolescents. We present normative data for women and an evaluation of the psychometric properties (internal consistency, convergent validity, and factor structure) of the Norwegian PHQ-9 among women with and without eating disorders (ED). METHODS: In this case-control study, a total of 793 females aged 18-78 years (mean 30.39; SD 9.83) completed an online self-report assessment. Measures included the ED100K and Eating Disorder Examination Questionnaire (EDE-Q) to assess ED psychopathology, and the Generalized Anxiety Disorder (GAD) scale and Difficulties in Emotion Regulation Scale Short Form (DERS-SF) to assess symptoms of anxiety and emotion regulation deficits. Participants were categorized into three groups, i.e., previous ED (19.7%, n = 148), current ED (36.3%, n = 272), and no history of ED (44.0%, n = 330), based on self-reported scores on the ED 100 K and the EDE-Q. RESULTS: Mean PHQ-9 total score for those with a previous history of ED was 10.67 (SD 6.33), for those with a current ED 16.61 (SD 5.84), and for those with no lifetime history of ED 6.83 (SD 5.58). Excellent internal consistency was demonstrated by Cronbach's alpha's for individuals with a previous ED (.88), for individuals with a current ED (.86), and for individuals with no history of ED (.88). Acceptable convergent validity was indicated based on significant correlations between the PHQ-9 and GAD-7 and DERS-SF. Confirmatory Factor Analyses revealed a mediocre fit for a one-factor structure of the PHQ-9, regardless of diagnostic status. CONCLUSIONS: The psychometric properties of the Norwegian version of the PHQ-9 are acceptable across females with and without ED, and the PHQ-9 can be recommended for use in clinical ED settings and for people without mental disorders.
BACKGROUND: Internationally, the Patient Health Questionnaire-9 (PHQ-9) is commonly used to assess the frequency and severity of depressive symptoms. However, psychometric properties of the Norwegian version of the PHQ-9 have only been assessed in adolescents. We present normative data for women and an evaluation of the psychometric properties (internal consistency, convergent validity, and factor structure) of the Norwegian PHQ-9 among women with and without eating disorders (ED). METHODS: In this case-control study, a total of 793 females aged 18-78 years (mean 30.39; SD 9.83) completed an online self-report assessment. Measures included the ED100K and Eating Disorder Examination Questionnaire (EDE-Q) to assess ED psychopathology, and the Generalized Anxiety Disorder (GAD) scale and Difficulties in Emotion Regulation Scale Short Form (DERS-SF) to assess symptoms of anxiety and emotion regulation deficits. Participants were categorized into three groups, i.e., previous ED (19.7%, n = 148), current ED (36.3%, n = 272), and no history of ED (44.0%, n = 330), based on self-reported scores on the ED 100 K and the EDE-Q. RESULTS: Mean PHQ-9 total score for those with a previous history of ED was 10.67 (SD 6.33), for those with a current ED 16.61 (SD 5.84), and for those with no lifetime history of ED 6.83 (SD 5.58). Excellent internal consistency was demonstrated by Cronbach's alpha's for individuals with a previous ED (.88), for individuals with a current ED (.86), and for individuals with no history of ED (.88). Acceptable convergent validity was indicated based on significant correlations between the PHQ-9 and GAD-7 and DERS-SF. Confirmatory Factor Analyses revealed a mediocre fit for a one-factor structure of the PHQ-9, regardless of diagnostic status. CONCLUSIONS: The psychometric properties of the Norwegian version of the PHQ-9 are acceptable across females with and without ED, and the PHQ-9 can be recommended for use in clinical ED settings and for people without mental disorders.
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