Cultural adaptation and psychometric properties of the 8-item Patient Health Questionnaire (PHQ-8) to screen for depression in southwestern Madagascar
Hervet J. Randriamady, Manasi Sharma, Rocky E. Stroud, Aroniaina M. Falinirina, Romario, Madeleine Rasoanirina, Nadège V. Volasoa, Frédéric Déclerque, Marc Y. Solofoarimanana, Jean C. Mahefa, Hanitra O. Randriatsara, Karestan C. Koenen, Christopher D. Golden

TL;DR
This paper adapts and validates a depression screening tool for use in southwestern Madagascar, showing it works well across different groups.
Contribution
The PHQ-8 was culturally adapted and validated for depression screening in Madagascar, with evidence of measurement invariance across demographic groups.
Findings
The one-factor depression model showed better fit (RMSEA=0.046, CFI=0.993) than the two-factor model.
The adapted PHQ-8 demonstrated good internal consistency (omega=0.81, alpha=0.87).
Measurement invariance was achieved across sex, ethnicity, education, and age groups.
Abstract
There have been no culturally validated measures to screen for depression in Madagascar. In 2022–2023, we conducted qualitative studies in the Bay of Ranobe area in southwestern Madagascar to understand local mental health syndromes specific to this region. We found that the 8-item Patient Health Questionnaire (PHQ-8) shares symptoms with the general distress-like, depressive-like and grief-like syndromes elicited locally. We adapted the PHQ-8 to align with the unique symptoms found in the region that were missing from the measure. We administered the adapted PHQ-8 to 809 participants aged 16 and above. We found that the one-factor (Depression) model (root mean square error of approximation [RMSEA] = 0.046, standardized root mean square residual [SRMR] = 0.053, Comparative Fit Index [CFI] = 0.993 and Tucker–Lewis Index [TLI] = 0.991) had a better fit to our data than the two-factor…
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Taxonomy
TopicsMental Health Treatment and Access
