Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry
BACKGROUND: Anxiety and depression frequently co-occur and represent a major global mental health burden, highlighting the need for efficient and psychometrically sound screening tools. The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief instrument widely used across cultures; however, evid...
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2026
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| author | Vilca Quiro, Lindsey Wildman Travezaño Cabrera, Aaron Italo Rojas-Jara, Claudio Moreta-Herrera, Rodrigo Puerta-Cortés, Diana Ximena Noe-Grijalva, Martin Yupanqui-Lorenzo, Daniel E. Chacón-Armijo, Sergio Cuesta-Andaluz, Evelyn |
| author_browse | Chacón-Armijo, Sergio Cuesta-Andaluz, Evelyn Moreta-Herrera, Rodrigo Noe-Grijalva, Martin Puerta-Cortés, Diana Ximena Rojas-Jara, Claudio Travezaño Cabrera, Aaron Italo Vilca Quiro, Lindsey Wildman Yupanqui-Lorenzo, Daniel E. |
| author_facet | Vilca Quiro, Lindsey Wildman Travezaño Cabrera, Aaron Italo Rojas-Jara, Claudio Moreta-Herrera, Rodrigo Puerta-Cortés, Diana Ximena Noe-Grijalva, Martin Yupanqui-Lorenzo, Daniel E. Chacón-Armijo, Sergio Cuesta-Andaluz, Evelyn |
| author_sort | Vilca Quiro, Lindsey Wildman |
| collection | Producción científica |
| description | BACKGROUND: Anxiety and depression frequently co-occur and represent a major global mental health burden, highlighting the need for efficient and psychometrically sound screening tools. The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief instrument widely used across cultures; however, evidence regarding its internal structure and cross-cultural equivalence from a psychometric network perspective remains limited, particularly in Latin America. The study aims to investigate the psychometric properties of the PHQ-4 from the perspective of psychometric networks in four Latin American countries. METHODS: A total of 1,887 participants aged 18 to 40 years were included in the study, distributed across the following countries: Chile (n = 353), Colombia (n = 467), Ecuador (n = 373), and Peru (n = 499). RESULTS: The EGA analysis showed that the items form a single community composed of four nodes with large network loadings in all four countries. The UVA analysis demonstrated that all items are relevant to the network model in all the countries analyzed. Evidence of structural consistency and item stability was also found, with the items being stable and systematically organized into a single community across all countries. Furthermore, the bootEGA analysis demonstrated that the PHQ-4 exhibits metric invariance across countries. CONCLUSIONS: The results of this study provide solid evidence of the psychometric performance of the PHQ-4 in the four countries studied. Therefore, a single-community structure is proposed to explain the internal structure of the PHQ-4. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/1017 |
| institution | UPeU |
| language | English |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/10172026-10-30T16:51:46ZPerformance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometryVilca Quiro, Lindsey WildmanTravezaño Cabrera, Aaron ItaloRojas-Jara, ClaudioMoreta-Herrera, RodrigoPuerta-Cortés, Diana XimenaNoe-Grijalva, MartinYupanqui-Lorenzo, Daniel E.Chacón-Armijo, SergioCuesta-Andaluz, EvelynDepressionAnxietyLatin AmericaNetwork StabilityCross-cultural InvarianceNetwork PsychometricsBACKGROUND: Anxiety and depression frequently co-occur and represent a major global mental health burden, highlighting the need for efficient and psychometrically sound screening tools. The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief instrument widely used across cultures; however, evidence regarding its internal structure and cross-cultural equivalence from a psychometric network perspective remains limited, particularly in Latin America. The study aims to investigate the psychometric properties of the PHQ-4 from the perspective of psychometric networks in four Latin American countries. METHODS: A total of 1,887 participants aged 18 to 40 years were included in the study, distributed across the following countries: Chile (n = 353), Colombia (n = 467), Ecuador (n = 373), and Peru (n = 499). RESULTS: The EGA analysis showed that the items form a single community composed of four nodes with large network loadings in all four countries. The UVA analysis demonstrated that all items are relevant to the network model in all the countries analyzed. Evidence of structural consistency and item stability was also found, with the items being stable and systematically organized into a single community across all countries. Furthermore, the bootEGA analysis demonstrated that the PHQ-4 exhibits metric invariance across countries. CONCLUSIONS: The results of this study provide solid evidence of the psychometric performance of the PHQ-4 in the four countries studied. Therefore, a single-community structure is proposed to explain the internal structure of the PHQ-4.Articlehttps://pubmed.ncbi.nlm.nih.gov/42249229https://doi.org/10.1186/s41155-026-00399-wPMC1346200310.1186/s41155-026-00399-whttps://hdl.handle.net/20.500.15037/101742249229W7163671624enPsicologia Reflexão e Crítica0102-79721678-71532026-06-062026-06-13T09:43:21Z2026-06-13T09:43:21Z |
| spellingShingle | Depression Anxiety Latin America Network Stability Cross-cultural Invariance Network Psychometrics Vilca Quiro, Lindsey Wildman Travezaño Cabrera, Aaron Italo Rojas-Jara, Claudio Moreta-Herrera, Rodrigo Puerta-Cortés, Diana Ximena Noe-Grijalva, Martin Yupanqui-Lorenzo, Daniel E. Chacón-Armijo, Sergio Cuesta-Andaluz, Evelyn Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry |
| title | Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry |
| title_full | Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry |
| title_fullStr | Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry |
| title_full_unstemmed | Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry |
| title_short | Performance of the Patient Health Questionnaire-4 (PHQ-4) in four latin American countries: rethinking the dimensionality of the scale from the perspective of network psychometry |
| title_sort | performance of the patient health questionnaire 4 phq 4 in four latin american countries rethinking the dimensionality of the scale from the perspective of network psychometry |
| topic | Depression Anxiety Latin America Network Stability Cross-cultural Invariance Network Psychometrics |
| topic_facet | Depression Anxiety Latin America Network Stability Cross-cultural Invariance Network Psychometrics |
| url | https://pubmed.ncbi.nlm.nih.gov/42249229 https://doi.org/10.1186/s41155-026-00399-w https://hdl.handle.net/20.500.15037/1017 |
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