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
Background:？Depression is frequently seen among pregnant women.？The？PHQ-9 is a diagnostic criteria-based screening instrument.？Objective:？The 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 bifactor model was significantly better in terms of goodness-of-fit indices:？χ2/df？= 1.030 (18), CFI =？0.999, RMSEA = 0.012. ECV suggested multidimensionality. Internal consistency was excellent:？ω？= 0.868,？
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