Adaptation and initial validation of the Patient Health Questionnaire - 9 (PHQ-9) and the Generalized Anxiety Disorder - 7 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample

Psychiatry Res. 2016 May 30;239:245-52. doi: 10.1016/j.psychres.2016.03.030. Epub 2016 Mar 17.


The Patient Health Questionnaire - 9 (PHQ-9) and Generalized Anxiety Disorder - 7 (GAD-7) are short screening measures used in medical and community settings to assess depression and anxiety severity. The aim of this study is to translate the screening tools into Arabic and evaluate their psychometric properties in an Arabic-speaking Lebanese psychiatric outpatient sample. The patients completed the questionnaires, among others, prior to being evaluated by a clinical psychiatrist or psychologist. The scales' internal consistency and factor structure were measured and convergent and discriminant validity were established by comparing the scores with clinical diagnoses and the Psychiatric Diagnostic Screening Questionnaire - MDD subset (PDSQ - MDD). Results showed that the PHQ-9 and GAD-7 are reliable screening tools for depression and anxiety and their factor structures replicated those reported in the literature. Sensitivity and specificity analyses showed that the PHQ-9 is sensitive but not specific at capturing depressive symptoms when compared to clinician diagnoses whereas the GAD-7 was neither sensitive nor specific at capturing anxiety symptoms. The implications of these findings are discussed in reference to the scales themselves and the cultural specificity of the Lebanese population.

Keywords: Anxiety; Arabic; Depression; Lebanon; Scale; Screening; Validation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis*
  • Depressive Disorder, Major / diagnosis*
  • Female
  • Humans
  • Lebanon
  • Male
  • Middle Aged
  • Outpatients
  • Psychiatric Status Rating Scales / standards*
  • Psychometrics / instrumentation
  • Psychometrics / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards