Yogyakarta, September 15, 2025 – A study titled “An Analysis of Measurement Invariance of the Patient Health Questionnaire-9 Between Indonesia, Germany, and the USA” authored by Eric Sucitra, Riangga Novrianto, Yolanda T. Pasaribu, Tania M. Lincoln, and Edo S. Jaya has been published in the journal Assessment. This journal is indexed in Scopus (Q1) and WoS (SSCI), with an Impact Factor of 3.4.
The research, which involved scholars from the Faculty of Psychology at Universitas Gadjah Mada (UGM), demonstrated that the Patient Health Questionnaire-9 (PHQ-9)—one of the most widely used instruments to measure depressive symptoms—can be applied universally regardless of a country’s per capita income level.
The study, which drew samples from Indonesia, Germany, and the United States, found that the PHQ-9 showed good measurement invariance at all levels and no significant differences in mean scores. These findings confirm that the PHQ-9 can be used to measure depressive symptoms in both high-income and low- to middle-income countries. The results also affirm that depressive symptoms are common across regions with different geographical contexts. This discovery may encourage the development of universal and accessible assessments and treatments for depression across diverse communities.
Abstract
The Patient Health Questionnaire-9 (PHQ-9) is a screening tool for assessing depressive symptomatology that has received widespread use. However, there is a scarcity of research on whether the instrument measures the same construct between high-income (HIC) and low- and middle-income countries (LMICs). Online surveys were utilized to assess samples across Indonesia, Germany, and the USA (N = 2350). Measurement Invariance (MI) was computed using multi-group confirmatory factor analyses. We found the general factor model to have a good fit and configural, metric, scalar, and residual MI across three countries. There were no significant differences in mean scores (Indonesia, M = 1.87, SD = 0.56; Germany, M = 1.90, SD = 0.65; USA, M = 1.90, SD = 0.75). These results highlight that depressive symptomatology is universal across distinct geographical regions, regardless of the population’s income levels. Hence, this study further emphasizes the urgency of developing universal, accessible assessment and treatment for depression.
Keywords: depression disorder, self-report, DSM, measurement invariance, cross-cultural
Link: https://doi.org/10.1177/10731911251361230
Based on the keywords, this article is an output that contributes to SDG 3, SDG 10, and SDG 17.
Congratulations to Riangga and the author team!
Writer: Fauzi
Editor: Zufar