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June 14, 2026International Journal of Methods in Psychiatric ResearchOpen Access

The Latent Structure of Depression and Anxiety Symptoms: A Bifactor Exploratory Structural Equation Model of the PHQ‐9 and GAD‐7 in Primary Care

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Authors

GEGabriel Esteller-ColladoMPMaider Prieto-VilaCACelia Antuña‐Camblor

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Overview

Randomized trial examines symptom structure in primary care, suggesting a dual focus in clinical assessments.

Key Points

  • This research aims to clarify the underlying structure of depression and anxiety symptoms using two validated tools.
  • Analyzed data from 1704 primary care patients participating in the PsicAP clinical trial.
  • Assessed dimensionality through Exploratory Graph Analysis and estimated models with Exploratory Structural Equation Modeling.
  • Compared model fit using fit indices such as CFI, TLI, RMSEA, and SRMR.
  • The bifactor model demonstrated the best fit for the data (CFI = 0.956; TLI = 0.928; RMSEA = 0.076; SRMR = 0.028).
  • The general factor of distress was relevant but not dominant, accounting for less variance (ECV = 0.40).
  • Well-defined specific factors for depression and anxiety were identified, with specific variance reliability of ωHS: 0.22 and 0.27.

Cite This Study

Esteller-Collado et al. (2026) studied this question.

synapsesocial.com/papers/6a2e465cb1cc60ccdea8b1b0https://doi.org/10.1002/mpr.70089
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