The DOI matches its Crossref record; 82 of the 86 references it cites were found in a registry or an index.
Adaptation and initial validation of the Patient Health Questionnaire – 9 (PHQ-9) and the Generalized Anxiety Disorder – 7 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample
Abstract
The Patient Health Questionnaire - 9 (PHQ-9) and Generalized Anxiety Disorder - 7 (GAD-7) are short screening measures used in medical and community settings to assess depression and anxiety severity. The aim of this study is to translate the screening tools into Arabic and evaluate their psychometric properties in an Arabic-speaking Lebanese psychiatric outpatient sample. The patients completed the questionnaires, among others, prior to being evaluated by a clinical psychiatrist or psychologist. The scales' internal consistency and factor structure were measured and convergent and discriminant validity were established by comparing the scores with clinical diagnoses and the Psychiatric Diagnostic Screening Questionnaire - MDD subset (PDSQ - MDD). Results showed that the PHQ-9 and GAD-7 are reliable screening tools for depression and anxiety and their factor structures replicated those reported in the literature. Sensitivity and specificity analyses showed that the PHQ-9 is sensitive but not specific at capturing depressive symptoms when compared to clinician diagnoses whereas the GAD-7 was neither sensitive nor specific at capturing anxiety symptoms. The implications of these findings are discussed in reference to the scales themselves and the cultural specificity of the Lebanese population.
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In the citing paper
“The Arabic version of PHQ-9 was previously validated in Lebanon [46].”
From Mindfulness among lebanese university students and its indirect effect between mental health and wellbeing (2023) · cites this paper as [46]
In the citing paper
“The Turkish and Arabic version of the scale has good psychometric properties (Sari et al., 2016;Sawaya et al., 2016).”
From "Doing What Matters in Times of Stress" to Decrease Psychological Distress During COVID-19: A Randomised Controlled Pilot Trial. (2022) · cites this paper as Sawaya et al., 2016
In the citing paper
“The PHQ-9 has been validated in the Lebanese population with a cut-off score of 10 or above indicating moderate depression [33].”
From Evaluating the Effectiveness of an E-Mental Health Intervention for People Living in Lebanon: Protocol for Two Randomized Controlled Trials (2021) · cites this paper as [33]
In the citing paper
“The GAD-7 has been validated in the Lebanese population [33].”
From Evaluating the Effectiveness of an E-Mental Health Intervention for People Living in Lebanon: Protocol for Two Randomized Controlled Trials (2021) · cites this paper as [33]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,766
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
The PHQ-9: A New Depression Diagnostic and Severity Measure
Kroenke, K., & Spitzer, R. L. (2002) · Psychiatric Annals · doi:10.3928/0048-5713-20020901-06 · Cited by 5,898
Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-5-200703060-00004 · Cited by 4,741
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008) · Medical Care · doi:10.1097/mlr.0b013e318160d093 · Cited by 4,527
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.03.006 · Cited by 4,057
Research works printed but not linked: 2
- Daradkeh, 2005, Mental morbidity in primary care in Al Ain (UAE): application of the Arabic translation of the PRIME-MD (PHQ) version, Ger. J. Psychiatry, 8, 32
- Hijazi, 2011, The integration of mental health into primary health care in Lebanon, Intervention, 9, 265
Cited by
Sorted by citations
Tiirikainen, K., Haravuori, H., Ranta, K., Kaltiala-Heino, R., & Marttunen, M. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2018.12.004 · Cited by 345
Meng, H., Xu, Y., Dai, J., Zhang, Y., Liu, B., & Yang, H. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112983 · Cited by 303
Lasheras, I., Gracia‐García, P., Lipnicki, D. M., Bueno‐Notivol, J., López‐Antón, R., de la Cámara, C., Lobo, A., & Santabárbara, J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17186603 · Cited by 308
Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study
Naser, A. Y., Hameed, A. N., Mustafa, N., Alwafi, H. H., Dahmash, E. Z., Alyami, H. S., & Khalil, H. Z. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.585534 · Cited by 309
Al-Musharaf, S. (2020) · Nutrients · doi:10.3390/nu12102923 · Cited by 195
Metadata
- Authors
- Sawaya, H., Atoui, M., Hamadeh, A., Zeinoun, P., & Nahas, Z.
- Affiliations
- American University of Beirut Medical Center (LB)
- Corresponding author
- Nahas, Ziad
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2016-05
- Volume
- 239
- Pages
- 245-252
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2298911878
- Cited by
- 450
- References
- 86
- Citations by year
- 2026: 54 · 2025: 77 · 2024: 62 · 2023: 55 · 2022: 65 · 2021: 69 · 2020: 35 · 2019: 15 · 2018: 11 · 2017: 6 · 2016: 1
- FWCI
- 15.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- PHQ-9, GAD-7, Arabic translation, depression screening, anxiety screening, psychometric validation, factor structure, sensitivity and specificity, psychiatric outpatients, Lebanese patients, cultural adaptation
- MeSH terms
- Adult, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Lebanon, Male, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Reproducibility of Results
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