Validity and Reliability of the Arabic Patient Health Questionnaire-9 in Patients with Spinal Cord Injury in Lebanon

Marwa Summaka, Hiba Zein, Linda Abou Abbas, Charbel Elias, Elias Elias, Youssef Fares, Ibrahim Naim, Zeina Nasser

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Depression is a prevalent and disabling condition associated with spinal cord injury (SCI). Such associated negative factor warrants the use of valid and reliable psychological assessment tools among this group. One of the available assessment means is the Patient Health Questionnaire-9 (PHQ-9), a short screening measure that evaluates depression status. Our aim is to test the psychometric properties of the Arabic version of the PHQ-9 including validity and reliability among Lebanese individuals with SCI. Methods: This is a cross-sectional study conducted between January and June 2018, including 51 participants with SCI. Questionnaire and assessment measures were administered to the subjects. The internal consistency, test-retest reliability, and the factor structure of the PHQ-9 were evaluated in addition to the convergent validity, which was established by comparing the scale's total score with the scores of the Hamilton Depression Rating Scale. Results: Exploratory factor analysis revealed 3 factors accounting for 66.2% of the total variance. The scale demonstrated good internal consistency (Cronbach's alpha = 0.71) and test-retest reliability (Intraclass correlation coefficient = 0.88). Significant correlation was found between the PHQ-9 and the Hamilton Depression Rating Scale (r = 0.71) suggesting good convergent validity. Conclusions: Our findings suggest that the PHQ-9 has good psychometric properties and is a valid and reliable measure of depression among the Lebanese individuals with SCI.

Original languageEnglish (US)
Pages (from-to)e1016-e1022
JournalWorld neurosurgery
StatePublished - May 2019
Externally publishedYes


  • Depression
  • Lebanon
  • Patient health Questionnaire-9
  • Psychometrics
  • Spinal cord injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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