Assessment of Depressive Symptoms During Inpatient Rehabilitation for Spinal Cord Injury: Is There an Underlying Somatic Factor When Using the PHQ?

James S. Krause, Charles Bombardier, Rickey E. Carter

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

Objective: To test the hypothesis that a 2-factor solution, including a somatic factor, best accounts for the response pattern to the Patient Health Questionnaire-9 (PHQ-9) during inpatient rehabilitation after spinal cord injury (SCI). Research Design: 568 adults with traumatic SCI were administered the PHQ-9 during inpatient rehabilitation. The PHQ-9 was developed to identify depressive disorders based on DSM-IV criteria. Results: Maximum likelihood confirmatory factor analysis was used to compare unidimensional and alternative 2-factor models. The results suggested that the 2-factor solution with 3 somatic items (sleep disturbance, poor energy, appetite change) was a better solution than either a unidimensional model or 2-factor model that included psychomotor retardation as a fourth somatic item. The root mean square error of approximation with 3 somatic items fell within the acceptable range of less than .08 (.073). The 2 factors were highly correlated (.76) but within the acceptable range (less than .80). Conclusions: There may be 2 underlying factors with the PHQ-9, including a somatic factor, when measuring depressive symptoms during inpatient rehabilitation for SCI.

Original languageEnglish (US)
Pages (from-to)513-520
Number of pages8
JournalRehabilitation Psychology
Volume53
Issue number4
DOIs
StatePublished - Nov 2008

Keywords

  • depression
  • disability
  • psychosocial
  • rehabilitation
  • spinal cord injury

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health

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