Measurement invariance by sex and age of the Patient Health Questionnaire (PHQ-4) in shipibo-konibo native communities of Ucayali, Perú

Introduction: the Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief instrument widely used for assessing symptoms of anxiety and depression; however, it lacks formal adaptation in Amazonian languages. Objective: to evaluate the measurement invariance of the Patient Health Questionnaire (PHQ-4) with respect to sex and age in Shipibo-Konibo native communities of Ucayali, Peru. Methodology: the study has a cross-sectional design.The linguistically and culturally adapted version of the PHQ-4 was administered to 150 participants selected by non-probability sampling. Results: Confirmatory Factor Analysis (CFA) showed that the unifactorial model of the Shipibo version of the PHQ-4 was the most appropriate and consistent with the holistic worldview of this community (CFI =.99, TLI =.97, SRMR =.03). Strict invariance was also observed by sex and age; no differences were found in mean scores between men and women, while differences were found according to age, with greater symptomatology in the 36 and older age group. Conclusion: the PHQ-4 is an invariant measure for assessing symptoms of anxiety and depression in different sex and age groups within the bilingual Shipibo-Konibo community.