Psychometric Analysis of the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) in Community Support Program Attendees in San Juan de Miraflores
DOI:
https://doi.org/10.26439/persona2025.n1.7808Keywords:
psychometric analysis, vulnerable communities, mental health, Patient Health Questionnaire for Depression and Anxiety (PHQ-4)Abstract
The adaptation of psychometric tests in the context of vulnerable populations in Lima Metropolitana is highly relevant due to its implications for diagnosis and assessment in mental health. This study aimed to identify the psychometric properties of the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) in attendees of community support programs in San Juan de Miraflores. The sample consisted of 115 participants (M = 37.2 years, SD = 9.20; 89.6 % females and 10.4 % males). Exploratory factor analysis identified a unidimensional structure as the best-fitting internal model. The analysis yielded internal consistency coefficients above the minimum thresholds established for research contexts. The study also established percentile-based norms for vulnerable communities. The discussion outlines the implications for psychometric assessment and preventive diagnostics in these populations and proposes directions for future research.
Downloads
References
Alegría, M., NeMoyer, A., Falgàs, I., Wang, Y., & Alvarez, K. (2018). Social determinants of mental health: Where we are and where we need to go. Current Psychiatry Reports, 20, 95. https://doi.org/10.1007/s11920-018-0969-9
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code
American Educational Research Association, American Psychological Association, & National Council on Measurement in Education. (2014). Standards for educational and psychological testing. American Educational Research Association.
Ato, M., López, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038-1059. https://dx.doi.org/10.6018/analesps.29.3.178511
Brown, T. A. (2015). Confirmatory factor analysis for applied research (2.a ed.). The Guilford Press.
Carranza Esteban, R. F., Mamani-Benito, O., Cjuno, J., Tito-Betancur, M., Caycho-Rodríguez, T., Vilca, L. W., Torales, J., & Barrios, I. (2024). Adaptación y validación de la Patient Health Questionnaire for Depression and Anxiety (PHQ-4) en una muestra de quechua hablantes peruanos. Medicina Clínica y Social, 8(1), 63-74. https://doi.org/10.52379/mcs.v8i1.361
Caycho-Rodríguez, T., Travezaño-Cabrera, A., Torales, J., Barrios, I., Vilca, L. W., Samaniego-Pinho, A., Moreta-Herrera, R., Reyes-Bossio, M., Barria-Asenjo, N. A., Ayala-Colqui, J., & Garcia-Cadena, C. H. (2024). Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population. Psicologia, Reflexao e Critica. Revista Semestral do Departamento de Psicologia da UFRGS, 37(1), 15. https://doi.org/10.1186/s41155-024-00299-x
Colegio de Psicólogos del Perú. (2024). Código de ética y deontología. https://www.cpsp.pe/documentos/marco_legal/CPsP_CDN_codigo_de_etica_y_deontologia.pdf
Cuamba, N., & Zazueta, N. (2020). Salud mental, habilidades de afrontamiento y rendimiento académico en estudiantes universitarios. Psicumex, 10(2), 71-94. https://doi.org/10.36793/psicumex.v10i2.351
Defensoría del Pueblo. (2020, 9 de octubre). Estado peruano debe priorizar la atención de la salud mental. https://www.defensoria.gob.pe/defensoria-del-pueblo-estado-peruano-debe-priorizar-la-atencion-de-la-salud-mental/
Ferrando, P. J., & Anguiano-Carrasco, C. (2010). El análisis factorial como técnica de investigación en psicología. Papeles del Psicólogo, 31(1), 18-33. https://www.redalyc.org/pdf/778/77812441003.pdf
Field, A. (2013). Discovering statistics using IBM SPSS Statistics (4.a ed.). Sage Publications.
García-Jiménez, M., & Trigo, M. (2025). Sesgos de género: un análisis de los factores que contribuyen a la desigualdad en la investigación psicológica. Apuntes de Psicología, 43(1), 37-48. https://doi.org/10.70478/apuntes.psi.2025.43.04
GEO PERÚ. (2024). San Juan de Miraflores https://visor.geoperu.gob.pe/reporte/150133
Giebel, C., Gabbay, M., Shrestha, N., Saldarriaga, G., Reilly, S., White, R., Liu, G., Allen, D., & Zuluaga, M. I. (2024). Community-based mental health interventions in low- and middle-income countries: A qualitative study with international experts. International Journal for Equity in Health, 23(1), 19. https://doi.org/10.1186/s12939-024-02106-6
International Test Commission. (2017). ITC guidelines for translating and adapting tests (2.a ed.). https://www.intestcom.org
Instituto Nacional de Salud Mental. (2021). Situación de la salud mental en el Perú 2020-2021. Ministerio de Salud. https://www.gob.pe/institucion/minsa/noticias/1037025-mas-de-1-300-000-casos-atendidos-por-trastornos-de-salud-mental-y-problemas-psicosociales
Jöreskog, K. (1977). Factor analysis by least-squares and maximum-likelihood methods. En K. Enslein, A. Ralston & H. Wilf (Eds.), Statistical methods for digital computers (pp. 125-153). John Wileyand Sons.
Keith, T. Z. (2019). Multiple regression and beyond. An introduction to multiple regression and structural equation modeling. Routledge.
Kerper, L., Spies, C., Tillinger, J., Wegscheider, K., Salz, A., Weiss-Gerlach, E., Neumann, T., & Krampe, H. (2014). Screening for depression, anxiety, and general psychological distress in pre-operative surgical patients: A psychometric analysis of the Patient Health Questionnaire 4 (PHQ-4). Clinical Health Promotion, 4(1), 5-14. http://dx.doi.org/10.29102/clinhp.14002
Kroenke, K., Spitzer, R., Williams, J., & Löwe, B. (2009). An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics, 50(6), 613-621. https://doi.org/10.1016/S0033-3182(09)70864-3
Leiva-Peña, V., Rubí-González, P., & Vicente-Parada, B. (2021). Determinantes sociales de la salud mental: políticas públicas desde el modelo biopsicosocial en países latinoamericanos. Revista Panamericana de Salud Pública, 45, 1-7. https://doi.org/10.26633/RPSP.2021.158
Lemmi, V. (2019). Sustainable development for global mental health: a typology and systematic evidence mapping of external actors in low-income and middle-income countries. BMJ Global Health, 4(6), e001826. http://doi.org/10.1136/bmjgh-2019-001826
Loehlin, J. C., & Beaujean, A. A. (2017). Latent variable models. An introduction to factor, path and structural equation analysis. Taylor & Francis.
López Guerra, V., Aguirre Mejía, A. J., & Guerrero Alcedo, J. M. (2022). Propiedades psicométricas y estructura factorial del cuestionario de salud del paciente PHQ-4 en estudiantes universitarios ecuatorianos. Revista Cubana de Enfermería, 38(3), Artículo e4885. https://revenfermeria.sld.cu/index.php/enf/article/view/4885
Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., Schneider, A., & Brähler, E. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122(1–2), 86–95. https://doi.org/10.1016/j.jad.2009.06.019
Materu, J., Kuringe, E., Nyato, D., Galishi, A., Mwanamsangu, A., Katebalila, M., Shao, A., Changalucha, J., Nnko, S., & Wambura, M. (2020). The psychometric properties of PHQ-4 Anxiety and Depression Screening Scale among out of school adolescent girls and young women in Tanzania: A cross-sectional study. BMC Psychiatry, 20(1), Artículo 321. https://doi.org/10.1186/s12888-020-02735-5
Marbin, D., Gutwinski, S., Schreiter, S., & Heinz, A. (2022). Perspectives in poverty and mental health. Frontiers in Public Health, 10, 1-7. https://doi.org/10.3389/fpubh.2022.975482
MacCallum, R.C., Widaman, K.F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4(1), 84-89. https://doi.org/10.1037/1082-989X.4.1.84
Meneses, J., Barrios, M., Bonillo, A., Cosculluela, A., Lozano, L., Turbany, J., & Valero, S. (2013). Psicometría. UOC.
Ministerio de Salud. (2022, 13 de enero). Minsa: más de 300 mil casos de depresión fueron atendidos durante el 2021. https://www.gob.pe/institucion/minsa/noticias/575899-minsa-mas-de-300-mil-casos-de-depresion-fueron-atendidos-durante-el-2021?utm_source=chatgpt.com
Ministerio de Salud. (2024, 12 de enero). La depresión es uno de los trastornos de salud mental más frecuentes en el país. https://www.gob.pe/institucion/minsa/noticias/892900-la-depresion-es-uno-de-los-trastornos-de-salud-mental-mas-frecuentes-en-el-pais?utm_source=chatgpt.com
Moreno, X., & Moreno, F. (2024). Factor structure and measurement invariance of the Patient Health Questionnaire-4 among the Chilean population. Plos One, 19(5), 1-12 https://doi.org/10.1371/journal.pone.0304623
Mundfrom, D. J., Shaw, D. G., Tian Lu, K. (2005). Minimum sample size recommendations for conducting factor analyses. International Journal of Testing, 5(2), 159–168. http://dx.doi.org/10.1207/s15327574ijt0502_4
Municipalidad Distrital de San Juan de Miraflores. (2024). Presupuesto institucional de apertura. Ejercicio fiscal 2024. https://cdn.www.gob.pe/uploads/document/file/5620312/4982505-acuerdo-de-concejo-n-069-2023-mdsjm-parte-i.pdf
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., Chisholm, D., Collins, P. Y., Cooper, J. L., Eaton, J., Herrman, H., Herzallah, M. M., Huang, Y., Jordans, M. J. D., Kleinman, A., Medina-Mora, M. E., Morgan, E., Niaz, U., Omigbodun, O., … UnÜtzer, Jü. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598.
Pfizer. (s. f.). Patient Health Questionnary (PHQ) Screeners. https://www.phqscreeners.com/
Redacción EC. (2023, 6 de diciembre). San Juan de Miraflores: nuevo Centro de Salud Mental Comunitaria Ricardo Palma beneficiará a más de 50 mil personas. El Comercio. https://elcomercio.pe/lima/san-juan-de-miraflores-nuevo-centro-de-salud-mental-comunitaria-ricardo-palma-beneficia-a-mas-de-50-000-personas-minsa-ultimas-noticia/?utm_source=chatgpt.com
Sanabria-Mazo, J. P., Gómez-Acosta, A., Castro-Muñoz, J. A., Rojas, Y. F., Feliu-Soler, A., & Luciano, J. V. (2023). Dimensionality and reliability of the online version of the Patient Health Questionnaire-4 (PHQ-4) in a large Colombian sample: Results from the PSY-COVID study. Current Psychology, 43, 11182-11192. https://doi.org/10.1007/s12144-023-05180-1
Thomson, B. (2004). Exploratory and confirmatory factor analysis. Understanding concepts and applications. American Psychological Association.
Viladrich, C., Angulo-Brunet, A., & Doval, E. (2017). A journey around alpha and omega to estimate internal consistency reliability. Anales de Psicología, 33(3), 755–782. https://doi.org/10.6018/analesps.33.3.268401
Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3(2), 171–178. https://doi.org/10.1016/S2215-0366(15)00505-2
World Health Organization. (2019). Human resources for mental health: Data by country. Peru. Global Health Observatory. https://data.who.int/countries/604
World Health Organization. (2022). World Mental Health Report. Transforming mental health for all.
Downloads
Published
Issue
Section
License
Acceptance for publication implies the transfer of printing and reproduction rights, by any form and means, to the publisher, while the author retains the intellectual property of the article.