Academic Journal
Measurement stability and differential domain-specific trajectories of the PHQ-9 in late-life depression: Evidence from a collaborative care trial.
| Τίτλος: | Measurement stability and differential domain-specific trajectories of the PHQ-9 in late-life depression: Evidence from a collaborative care trial. |
|---|---|
| Συγγραφείς: | Ndukwe R; Research Ireland Centre for Research Training in Foundations of Data Science, University of Limerick, Limerick, Ireland; Data-Driven Computer Engineering Research Centre (D(2)ICE), University of Limerick, Limerick, Ireland; Health Research Institute (HRI), University of Limerick, Limerick, Ireland. Electronic address: ndukwe.rebecca@ul.ie., Scazufca M; Department of Psychiatry, Faculty of Medicine, Universidade de São Paulo (FMUSP); Laboratory of Psychopathology and Psychiatric Therapeutics (LIM-23), Institute of Psychiatry, Hospital das Clínicas (IPq-HCFMUSP), São Paulo, Brazil., Van de Ven P; Data-Driven Computer Engineering Research Centre (D(2)ICE), University of Limerick, Limerick, Ireland; Health Research Institute (HRI), University of Limerick, Limerick, Ireland. |
| Πηγή: | Journal of affective disorders [J Affect Disord] 2026 Nov 15; Vol. 413, pp. 122171. Date of Electronic Publication: 2026 Jun 27. |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press. |
| Ιατρικοί όροι (MeSH): | Depression*/diagnosis , Depression*/psychology , Depression*/therapy , Patient Health Questionnaire*, Fatigue/psychology ; Humans ; Female ; Aged ; Male ; Middle Aged ; Longitudinal Studies ; Suicidal Ideation |
| Περίληψη: | Background: The Patient Health Questionnaire-9 (PHQ-9) is routinely used to monitor depressive symptoms. However, whether its empirically derived two-factor structure remains stable across repeated assessments in clinically depressed populations is not well established. Methods: Using item-level data from a secondary analysis of the PROACTIVE cluster-randomised controlled trial (N=558; PHQ-9 ≥10 at baseline; aged ≥60 years), we evaluated longitudinal measurement invariance of an empirically derived two-factor PHQ-9 structure across three assessment points using WLSMV structural equation modelling with multiple imputation. We then modelled domain-specific latent growth trajectories by trial arm and examined within-person temporal dynamics using a random intercept cross-lagged panel model (RI-CLPM). Results: Metric invariance was supported and partial scalar invariance achieved across all three time points, after freeing thresholds for three interpretable items (sleep disturbance, fatigue, and suicidal ideation). The intervention was associated with a steeper improvement in cognitive-affective symptoms but showed no significant effect on somatic symptom trajectories. Within-person somatic deviations at baseline were temporally associated with subsequent cognitive-affective deviations, whereas the reverse was not. Conclusions: The two-factor structure of the PHQ-9 is metrically stable through clinical recovery in older adults with moderate-to-severe depression. Domain-specific subscores capture differential treatment response and temporal symptom dynamics that total scores conceal, and can be calculated from existing PHQ-9 items at no additional burden. These findings support the routine use of domain-level monitoring in collaborative care programmes serving older adults in low- and middle-income country (LMIC) settings. (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Collaborative care; Cross-lagged; Depression; Longitudinal invariance; Older adults; PHQ-9; Trajectories |
| Entry Date(s): | Date Created: 20260627 Date Completed: 20260723 Latest Revision: 20260723 |
| Update Code: | 20260724 |
| DOI: | 10.1016/j.jad.2026.122171 |
| PMID: | 42364659 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1573-2517 |
|---|---|
| DOI: | 10.1016/j.jad.2026.122171 |