THE STRUCTURE OF THE PATIENT HEALTH QUESTIONNAIRE-9 IN PREGNANT WOMEN IN SPAIN

Abstract Objective To evaluate psychometric properties and the factor structure of the Spanish version of the Patient Health Questionnaire (PHQ-9) in pregnant women received care in an urban public hospital in Spain. Research design/setting In a cross-sectional study, the reliability and factor structure were examined. Exploratory and confirmatory factor analyses were conducted to examine the latent structure of the PHQ-9 with a pregnant Spanish-speaking sample ( n  = 445) recruited during the first trimester in an obstetrics clinic in Madrid. Measurements and findings The Spanish version of PHQ-9 had moderate internal consistency ( α  = 0.81). Exploratory factor analysis revealed a two-factor (cognitive-affective, somatic) and three-factor (cognitive-affective, somatic, pregnancy-related) structure of the PHQ-9, whereas confirmatory factor analyses support a three-factor model (cognitive-affective, somatic, pregnancy-related) as the best fit to the data. Key Conclusions The Spanish version of PHQ-9 is reliable and can be used to screen for depression during pregnancy. A three-factor model structure is adequate to evaluate the components and symptoms of depression for Spanish pregnant women. Implication for practice Midwives can screen for depression during the PHQ-9 and can tailor interventions to minimize the adverse effects on mothers and infants, before and after birth.