Psychometric properties of the Armenian and Georgian versions of the PHQ-9, GAD-7, and WHO-5 well-being index

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Abstract Background Depressive and anxiety disorders are highly prevalent among healthcare workers. A survey was conducted in Armenia, Georgia, Moldova, and Ukraine to map their mental health as an extension of a previous study to improve the 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 neither available nor validated in Armenian or Georgian. Assessment of their psychometric properties is needed to validate their applicability. Methods We conducted a cross-sectional survey study. Translations were coordinated by the World Health Organization (WHO) Regional and Country Offices. A pilot study helped identify translation errors. The survey was open from May to September 2025. We used Cronbach’s α and McDonald’s ω to test for internal consistency, exploratory and confirmatory factor analyses for construct validity, Pearson’s correlation for discriminant validity, and Multiple-Group Confirmatory Factorial Analyses for measurement invariance. We analysed 3,364 valid responses from Armenian and Georgian doctors and nurses. Results Analyses indicated overall good internal consistency with Cronbach’s α and McDonald’s ω ranging between 0.8 and 0.9. The factor loadings ranged between 0.38 and 0.76, and the Comparative Fit Indices (CFI), Tucker-Lewis indices (TLI), Root-Mean-Square Error of Approximation (RMSEA), and Standardised Root-Mean-Squared Residual (SRMR) indices were appropriate even across 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 scores and the WHO-5 score indicated divergent validity. Conclusions The Armenian and Georgian versions of the PHQ-9, GAD-7, and WHO-5 showed generally acceptable reliability and partial support for construct validity within this specific sample of healthcare workers. Although these findings provide a foundation for future research, the reliance on a specific sample of healthcare professionals and the absence of validation against a diagnostic gold standard limit their immediate clinical applicability. Consequently, further validation in representative populations is required before these instruments can be broadly implemented in routine practice.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.