Psychometric properties of the Hausa versions of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 among internally displaced adults

Abstract

ABSTRACT Objective Brief depression and anxiety measures are widely used in humanitarian settings, but their psychometric performance may vary across populations. We evaluated the reliability, factor structure, and construct validity of the Hausa PHQ-9 and GAD-7 among internally displaced adults in Abuja, Nigeria. Methods Cross-sectional psychometric analysis of 228 adults enrolled in the RESETTLE-IDPs trial at Durumi and Wassa camps. Trained facilitators administered the Hausa PHQ-9 and GAD-7. Reliability was assessed using Cronbach’s alpha, McDonald omega, ordinal alpha, and item-level statistics. Weighted least squares mean- and variance-adjusted confirmatory factor analysis compared one-factor, correlated two-factor, bifactor, and residual-covariance models. Joint models compared general distress with correlated depression and anxiety factors. Spearman correlations assessed associations with related constructs; ordinary least squares regression with HC3 standard errors assessed adjusted associations with participant characteristics. Results Reliability was acceptable for the PHQ-9 (α = .80; ω = .82) and GAD-7 (α = .78; ω = .80). The PHQ-9 was best characterized as unidimensional, whereas the GAD-7 showed closely related but distinguishable cognitive and somatic dimensions. Bifactor modeling provided no clear advantage for the PHQ-9 and did not converge for the GAD-7. In joint modeling, depression and anxiety were strongly correlated but remained distinct (r = .82). In adjusted analyses, PCL-5 scores were associated with both PHQ-9 and GAD-7 scores, and age was also associated with GAD-7 scores. Conclusion The Hausa PHQ-9 and GAD-7 showed adequate psychometric performance for assessing depressive and anxiety symptom severity among internally displaced adults in this sample.