Background:

Mental health is an important issue in general practice/family medicine. The Patient Health Questionnaire for Depression and Anxiety (PHQ-4) allows depression and anxiety screening and psychologic distress evaluation. PHQ-4 cross-cultural adaptation and concurrent validation was the objective of this paper in a population of general practice/family medicine (GP/FM) doctors.

Methods:

Translation, linguistic verification and back-translation, internal consistency, and reliability of the final translated tool were performed for the cultural adaptation of the PHQ-4 scale. The European Quality of Life 5 Dimensions 3L (EQ-5D-3L) scale and the “Sentimentos Negativos - Negative Feelings”, subscale of the “Questionário da Avaliação da Sobrecarga da Gestão da Multimorbilidade em Medicina Geral e Familiar - Questionnaire of Evaluation of Burden of Management of Multimorbidity in General Practice and Family Medicine” [SoGeMM-MGF]) were used for concurrent validation. Descriptive, inferential, and correlational statistics were used, according to the distribution of data, with a p-value of <0.01 for statistical significance being defined.

Results:

Forty-six participants (50.0% women, 39.1% less than 35 years) were enrolled in the cultural adaptation phase. The PHQ-4 scale’s internal consistency was Cronbach’s Alfa 0.762 (test) and 0.764 (retest), and the Intraclass Correlation Coefficient of 0.762. No significant differences by question or total score between both applications were found (p>0.01). The concurrent validation phase included 91 participants (28.6% men, 78.9% less than 45 years). The convergent validity of the PHQ-4 scale was confirmed by the moderate, positive, significant correlation with the “Anxiety/Depression” domain of the EQ-5D-3L scale (Spearman ρ=0.577; p<0.001) and with the moderate, positive, significant correlation with “Sentimentos Negativos - Negative Feelings”, subscale from the SoGeMM-MGF questionnaire (Spearman ρ=0.518; p<0.001).

Conclusion:

PHQ-4 scale cultural adaptation and concurrent validity were made, PHQ4 being a valid and reliable screening tool, to assess anxiety, depression, and psychological distress.

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