Mixed-Method Evaluation of the Public Health Questionnaire for Estimating Depression Among Tibetan Buddhist Monastics

Background: Depression is the largest source of global medical disability, highlighting importance translating and validating depression screening instruments to improve our understanding differences in prevalence divergent cultures around world. The aim this study was translate evaluate a widely used diagnostic instrument, Patient Health Questionnaire-9 (PHQ-9), for use with Tibetan populations. A secondary Tibetan-PHQ-9 (T-PHQ-9) estimate symptoms population Tibetan-speaking Buddhist monastic scholars engaging 6-year science curriculum India, Emory Tibet Science Initiative (ETSI). Methods: Three-hundred-eighty-four monastics (363 monks, 21 nuns) completed T-PHQ-9. We computed measures internal consistency conducted factor analysis scale performance. Following this, we evaluated depressive among population. also cognitive interviews six explore their thought processes when completing instrument thinking about symptoms. Results: T-PHQ-9 had acceptable reliability demonstrated single-factor structure. While having low energy most commonly endorsed symptom, did not have overall higher endorsement rates other somatic compared emotional Over 10% scored moderately severe range met criteria major disorder using standard cut-offs. First year monks highest mean score, there significant difference between nuns. Cognitive revealed some variation complete particularly related concentration. Conclusion: These preliminary findings indicate that PHQ-9 reliable assessing symptoms, as evidenced by its ability inform how are experienced, interpreted, communicated monastics. Results from may be important further refining instrument.