Obeid, SaharHemade, AliMalaeb, DianaSakr, FouadDabbous, MariamXu, JialeYing, YiweiJiang, ChenMeng, RuntangFekih-Romdhane, FetenHallit, Souheil2024-10-172024-10-172024-07-30Obeid, S., Hemade, A., Malaeb, D. et al. Psychometric properties of the ultra-brief self-report Patient Health Questionnaire-4 (PHQ-4) to assess anxiety and depression in Arabic-speaking adults. BMC Psychiatry 24, 537 (2024). https://doi.org/10.1186/s12888-024-05978-810.1186/s12888-024-05978-8http://hdl.handle.net/20.500.14131/1820Background Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-efective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely benefcial. The study aimed to translate the four-item composite Patient Health Questionnaire – 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress. Methods 587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4. Results Confrmatory factor analysis (CFA) indicated that ft of the two-factor model of the PHQ-4 scores was modest (χ 2 / df=.13/1=.13, RMSEA=.001, SRMR=.002, CFI=1.005, TLI=1.000). Internal reliability was excellent (McDonald’s omega=.86; Cronbach’s alpha=.86). Indices suggested that confgural, metric, and scalar invariance were supported acrosssex. No significant diference wasfound between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were signifcantly and moderately-tostrongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores. Conclusion The PHQ-4 proves to be a reliable, valid, and cost-efective tool for assessing symptoms related to depression and anxiety. To evaluate the practical efectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specifc populationsendepressionAnxiety, Arabic, Depression, Patient Health Questionnaire, Psychometric properties, ValidationNA