Cross-cultural validity of the WHO-5 Well-Being Index and Euthymia Scale: A clinimetric analysis

Danilo Carrozzino, Kaj Sparle Christensen, Chiara Patierno, Agnieszka Woźniewicz, Stine Bjerrum Møller, Ida-Marie T P Arendt, Yuqun Zhang, Yonggui Yuan, Natsu Sasaki, Daisuke Nishi, Carmen Berrocal Montiel, Sara Ceccatelli, Giovanni Mansueto, Fiammetta Cosci*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The assessment of psychological well-being and euthymia represents an emerging issue in clinical psychology and psychiatry. Rating scales and indices such as the 5-item version of the World Health Organization Well-Being Index (WHO-5) and the Euthymia Scale (ES) were developed but insufficient attention has been devoted to the evaluation of their cross-cultural validity. This is the first study using Clinimetric Patient-Reported Outcome Measures (CLIPROM) criteria to assess cross-cultural validity and sensitivity of five different versions of the WHO-5 and ES.

METHODS: A multicenter cross-sectional study involving a total of 3762 adult participants from different European (i.e., Italy, Poland, Denmark) and non-European (i.e., China, Japan) countries was conducted. Item Response Theory models (Mokken and Rasch analyses) were applied.

RESULTS: Mokken coefficients of scalability were found to range from 0.42 to 0.84. The majority of the versions of the WHO-5 fitted the Rasch model expectations. Paired t-tests revealed that the Italian and Danish WHO-5 versions were unidimensional. Person Separation Reliability indices showed that the Polish, Danish, and Japanese ES versions could reliably discriminate between subjects with different levels of euthymia.

LIMITATIONS: A convenience sampling was used, thus limiting the generalizability of study findings. In addition, no measures of negative mental health were administered.

CONCLUSIONS: WHO-5 can be used in international studies for cross-cultural comparisons since it covers transcultural components of subjective well-being. Findings also suggest that the ES can be used as a cross-cultural screening tool since it entailed the clinimetric property of sensitivity.

Original languageEnglish
Pages (from-to)276-283
Number of pages8
JournalJournal of Affective Disorders
Volume311
Early online date21 May 2022
DOIs
Publication statusPublished - 15 Aug 2022

Keywords

  • CONSTRUCT
  • COUNTRIES
  • CRITERIA
  • Clinimetrics
  • Cross-cultural
  • DEPRESSION
  • Euthymia
  • HEALTH-STATUS QUESTIONNAIRES
  • POSITIVE MENTAL-HEALTH
  • Psychological well-being
  • RASCH MEASUREMENT MODEL
  • RELIABILITY
  • SCIENCE
  • Sensitivity
  • TRANSLATIONS
  • Validity

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