Psychometric properties of the Armenian and Georgian versions of the PHQ-9, GAD-7, and WHO-5 Well-Being Index

Background Depressive and anxiety disorders are highly prevalent on healthcare personnel. A survey was conducted in Armenia, Georgia, Moldova, and Ukraine to map their mental health as an extension of a previous study to improve sustainability of health systems. The Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), and the WHO 5-item well-being index (WHO-5) were used as screening tools. These were not available nor validated in Armenian nor Georgian. Assessment of their psychometric properties is needed to validate their applicability. Methods We did a cross-sectional study. Translations coordinated by the WHO Regional and Country Offices were done. A pilot study helped identify translation errors. The survey was open for three months, results were used to test for internal consistency, construct validity, discriminant validity, and measurement invariance. We analysed 3,353 valid responses. Results Analyses indicated overall good internal consistency with Cronbach’s α and McDonald’s ω between 0.8–0.9. The factor loadings ranged between 0.38 and 0.76, and the CFI, TLI, RMSEA, and SRMR indices were appropriate even through measurement invariance tests. The strong positive correlation (r = 0.75–0.78) between the PHQ-9 and GAD-7 scores suggested convergent validity, whereas a negative correlation (r = − 0.59 to -0.51) between these and the WHO-5 score indicated divergent validity. Conclusions Applicability of the PHQ-9, GAD-7 and WHO-5 in Armenia and Georgia was proved. These need adequate translation and assessment for use in the clinical practice. Two main limitations were present, the sample comprised only healthcare professionals, and no validation against a gold standard was conducted.