Factor structure of PHQ-9 in perinatal period: A longitudinal study

Abstract

Background: Screening for perinatal depression (PD) is challenging due to the overlap of symptoms with pregnancy and postpartum. The PHQ-9 is a commonly used diagnostic tool, and understanding its factor structure is crucial. Aim: To assess the three-factor factor structure of the PHQ-9 and its longitudinal stability during the perinatal stage. Methods: The study involved 205 women from a Spanish hospital, collecting data during the third trimester, immediate postpartum and six weeks postpartum. Statistical analyses, including confirmatory factor analysis, were performed to assess the stability of the factor structure and reliability of the PHQ-9. Results: The three-factor model of the PHQ-9, comprising cognitive-affective, somatic and pregnancy-related symptoms, was stable during pregnancy and postpartum, except in the immediate postpartum period. Analyses supported the validity of the PHQ-9 during the perinatal stage. Conclusions: Understanding the factors contributing to depressive symptoms during the perinatal period is crucial. Although the three-factor model is robust, caution is advised in the immediate postpartum period due to symptom overlap. The PHQ-9 is a reliable tool for assessing and intervening in depressive symptoms