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Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China: A Transcultural Structural Equation Modeling (SEM) Study

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Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China : A Transcultural Structural Equation Modeling (SEM) Study. / Leonhart, R.; de Vroege, Lars; Schaefert, Rainer; Nolte, Sandra; Fischer, Felix H; Fritzsche, K.; van der Feltz-Cornelis, C.M.; Zhang, Lan; Liu, Yang; Dong, Zaiquan.

In: Frontiers in Psychology, Vol. 9, 240, 26.06.2018.

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Leonhart, R, de Vroege, L, Schaefert, R, Nolte, S, Fischer, FH, Fritzsche, K, van der Feltz-Cornelis, CM, Zhang, L, Liu, Y & Dong, Z 2018, 'Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China: A Transcultural Structural Equation Modeling (SEM) Study', Frontiers in Psychology, vol. 9, 240. https://doi.org/10.3389/fpsyt.2018.00240

APA

Leonhart, R., de Vroege, L., Schaefert, R., Nolte, S., Fischer, F. H., Fritzsche, K., ... Dong, Z. (2018). Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China: A Transcultural Structural Equation Modeling (SEM) Study. Frontiers in Psychology, 9, [240]. https://doi.org/10.3389/fpsyt.2018.00240

Vancouver

Leonhart R, de Vroege L, Schaefert R, Nolte S, Fischer FH, Fritzsche K et al. Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China: A Transcultural Structural Equation Modeling (SEM) Study. Frontiers in Psychology. 2018 Jun 26;9. 240. https://doi.org/10.3389/fpsyt.2018.00240

Author

Leonhart, R. ; de Vroege, Lars ; Schaefert, Rainer ; Nolte, Sandra ; Fischer, Felix H ; Fritzsche, K. ; van der Feltz-Cornelis, C.M. ; Zhang, Lan ; Liu, Yang ; Dong, Zaiquan. / Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China : A Transcultural Structural Equation Modeling (SEM) Study. In: Frontiers in Psychology. 2018 ; Vol. 9.

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@article{be1ae0dbaca84cf4873ad12329ee374f,
title = "Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China: A Transcultural Structural Equation Modeling (SEM) Study",
abstract = "BackgroundPersistent somatic symptoms are associated with psychological distress, impaired function, and medical help-seeking behavior. The Patient Health Questionnaire (PHQ)-15 is used as a screening instrument for somatization and as a monitoring instrument for somatic symptom severity. A bifactorial model has been described, with one general factor and four orthogonal specific symptom factors. The objective of the present study was to assess and to clarify the factor structure of the PHQ-15 within and between different countries in Western Europe and China.MethodCross-sectional secondary data analysis performed in three patient data samples from two Western European countries (Germany N = 2,517, the Netherlands N = 456) and from China (N = 1,329). Confirmatory factor analyses (CFA), and structural equation modeling (SEM) analysis were performed.ResultsThe general factor is found in every sample. However, although the outcomes of the PHQ-15 estimate severity of somatic symptoms in different facets, these subscales may have different meanings in the European and Chinese setting. Replication of the factorial structure was possible in the German and Dutch datasets but not in the dataset from China. For the Chinese dataset, a bifactorial model with a different structure for the cardiopulmonary factor is suggested. The PHQ-15 could discern somatization from anxiety and depression within the three samples.ConclusionThe PHQ-15 is a valid questionnaire that can discern somatization from anxiety and depression within different cultures like Europe or China. It can be fitted toa bifactorial model for categorical data, however, the model can only be recommended for use of the general factor. Application of the orthogonal subscales in non-European samples is not corroborated by the results. The differences cannot be ascribed to differences in health care settings or by differences in concomitant depression or anxiety but instead, a cultural factor involving concepts of disease may play a role in this as they may play a role in the translation of the questionnaire. Further research is needed to explore this, and replication studies are needed regarding the factorial structure of the PHQ-15 in China.",
author = "R. Leonhart and {de Vroege}, Lars and Rainer Schaefert and Sandra Nolte and Fischer, {Felix H} and K. Fritzsche and {van der Feltz-Cornelis}, C.M. and Lan Zhang and Yang Liu and Zaiquan Dong",
note = "{\circledC} 2018 Leonhart, de Vroege, Zhang, Liu, Dong, Schaefert, Nolte, Fischer, Fritzsche and van der Feltz-Cornelis.",
year = "2018",
month = "6",
day = "26",
doi = "10.3389/fpsyt.2018.00240",
language = "English",
volume = "9",
journal = "Frontiers in Psychology",
issn = "1664-1078",
publisher = "Frontiers Media S.A.",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Comparison of the Factor Structure of the Patient Health Questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China

T2 - Frontiers in Psychology

AU - Leonhart, R.

AU - de Vroege, Lars

AU - Schaefert, Rainer

AU - Nolte, Sandra

AU - Fischer, Felix H

AU - Fritzsche, K.

AU - van der Feltz-Cornelis, C.M.

AU - Zhang, Lan

AU - Liu, Yang

AU - Dong, Zaiquan

N1 - © 2018 Leonhart, de Vroege, Zhang, Liu, Dong, Schaefert, Nolte, Fischer, Fritzsche and van der Feltz-Cornelis.

PY - 2018/6/26

Y1 - 2018/6/26

N2 - BackgroundPersistent somatic symptoms are associated with psychological distress, impaired function, and medical help-seeking behavior. The Patient Health Questionnaire (PHQ)-15 is used as a screening instrument for somatization and as a monitoring instrument for somatic symptom severity. A bifactorial model has been described, with one general factor and four orthogonal specific symptom factors. The objective of the present study was to assess and to clarify the factor structure of the PHQ-15 within and between different countries in Western Europe and China.MethodCross-sectional secondary data analysis performed in three patient data samples from two Western European countries (Germany N = 2,517, the Netherlands N = 456) and from China (N = 1,329). Confirmatory factor analyses (CFA), and structural equation modeling (SEM) analysis were performed.ResultsThe general factor is found in every sample. However, although the outcomes of the PHQ-15 estimate severity of somatic symptoms in different facets, these subscales may have different meanings in the European and Chinese setting. Replication of the factorial structure was possible in the German and Dutch datasets but not in the dataset from China. For the Chinese dataset, a bifactorial model with a different structure for the cardiopulmonary factor is suggested. The PHQ-15 could discern somatization from anxiety and depression within the three samples.ConclusionThe PHQ-15 is a valid questionnaire that can discern somatization from anxiety and depression within different cultures like Europe or China. It can be fitted toa bifactorial model for categorical data, however, the model can only be recommended for use of the general factor. Application of the orthogonal subscales in non-European samples is not corroborated by the results. The differences cannot be ascribed to differences in health care settings or by differences in concomitant depression or anxiety but instead, a cultural factor involving concepts of disease may play a role in this as they may play a role in the translation of the questionnaire. Further research is needed to explore this, and replication studies are needed regarding the factorial structure of the PHQ-15 in China.

AB - BackgroundPersistent somatic symptoms are associated with psychological distress, impaired function, and medical help-seeking behavior. The Patient Health Questionnaire (PHQ)-15 is used as a screening instrument for somatization and as a monitoring instrument for somatic symptom severity. A bifactorial model has been described, with one general factor and four orthogonal specific symptom factors. The objective of the present study was to assess and to clarify the factor structure of the PHQ-15 within and between different countries in Western Europe and China.MethodCross-sectional secondary data analysis performed in three patient data samples from two Western European countries (Germany N = 2,517, the Netherlands N = 456) and from China (N = 1,329). Confirmatory factor analyses (CFA), and structural equation modeling (SEM) analysis were performed.ResultsThe general factor is found in every sample. However, although the outcomes of the PHQ-15 estimate severity of somatic symptoms in different facets, these subscales may have different meanings in the European and Chinese setting. Replication of the factorial structure was possible in the German and Dutch datasets but not in the dataset from China. For the Chinese dataset, a bifactorial model with a different structure for the cardiopulmonary factor is suggested. The PHQ-15 could discern somatization from anxiety and depression within the three samples.ConclusionThe PHQ-15 is a valid questionnaire that can discern somatization from anxiety and depression within different cultures like Europe or China. It can be fitted toa bifactorial model for categorical data, however, the model can only be recommended for use of the general factor. Application of the orthogonal subscales in non-European samples is not corroborated by the results. The differences cannot be ascribed to differences in health care settings or by differences in concomitant depression or anxiety but instead, a cultural factor involving concepts of disease may play a role in this as they may play a role in the translation of the questionnaire. Further research is needed to explore this, and replication studies are needed regarding the factorial structure of the PHQ-15 in China.

U2 - 10.3389/fpsyt.2018.00240

DO - 10.3389/fpsyt.2018.00240

M3 - Article

VL - 9

JO - Frontiers in Psychology

JF - Frontiers in Psychology

SN - 1664-1078

M1 - 240

ER -