Cross-cultural adaptation of the PHQ-4 to European Portuguese and its validation with the psychological burden by the multimorbidity management in GP/FM practice in Central Portugal

Background: Mental health is an important issue in general practice/family medicine. The Patient Health Questionnaire for Depression and Anxiety (PHQ-4) allows depression and anxiety screening and psychologic distress evaluation. PHQ-4 cross-cultural adaptation and concurrent validation was the objective of this paper in a population of general practice/family medicine (GP/FM) doctors. Methods: Translation, linguistic verification and back-translation, internal consistency, and reliability of the final translated tool were performed for the cultural adaptation of the PHQ-4 scale. The European Quality of Life 5 Dimensions 3L (EQ-5D-3L) scale and the “Sentimentos Negativos – Negative Feelings”, subscale of the “Questionário da Avaliação da Sobrecarga da Gestão da Multimorbilidade em Medicina Geral e Familiar – Questionnaire of Evaluation of Burden of Management of Multimorbidity in General Practice and Family Medicine” [SoGeMM-MGF]) were used for concurrent validation. Descriptive, inferential, and correlational statistics were used, according to the distribution of data, with a p-value of <0.01 for statistical significance being defined. Conclusion: PHQ-4 scale cultural adaptation and concurrent validity were made, PHQ4 being a valid and reliable screening tool, to assess anxiety, depression, and psychological distress.