Document Type : Original Article
Assistant Professor, Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran. E-mail: S.A.Hosseini@Alzahra.ac.ir
The Mental Health Inventory-5 (MHI-5) is a valid and reliable brief instrument for assessing mental health internationally. This study aimed to investigate the validity of the Persian version of the MHI-5 among the Iranian adult population. Data were collected electronically from December 2020 to June 2020 using social networks (Google form). The questionnaire gathered information on demographics, the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Mental Health Inventory-28 (MHI-28), and Mental Health Inventory-5 (MHI-5). Content validity was assessed, and internal consistency was evaluated using Cronbach's alpha. Descriptive and correlational analyses were conducted on 1208 participants with a mean age of 32.80±12.37 years, of which 29.3% were male. The internal consistency for the Persian MHI-5 scale was 0.85 and Cronbach's alpha 0.78. Item-total correlations ranged from 0.49 to 0.52. The mean total score was 15.25±2.50. Negative statistically significant correlations were found between the Persian MHI-5 and anxiety/depression scores (p<0.05), demonstrating valid criterion validity. The findings support the reliability and validity of the Persian MHI-5 for screening mental illness among the general Iranian population. A short inventory such as the MHI-5 can effectively aid healthcare systems in mental health screening.
- World Health Organization. Preamble to the constitution of the World Health Organization. Off Rec World Health Organ. 1948;2:100.
- World Health Organization. Promoting mental health: Concepts, emerging evidence, practice (Summary Report). Geneva: World Health Organization; 2004.
- Christensen MK, Lim CCW, Saha S, et al. The cost of mental disorders: A systematic review. Epidemiology and Psychiatric Sciences. 2020;29:e161.
- Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nordic Journal of Psychiatry. 2003;57:113–8.
- Rumpf HJ, et al. Screening for mental health: Validity of the MHI-5 using DSM-IV axis I psychiatric disorders as gold standards. Psychiatry Research. 2001;105(3):243-53.
- Santos AM, Novo RF. Mental Health Inventory: Sensitivity and specificity of the Portuguese version of the MHI-38 and MHI-5. Psychological Reports. 2020;123(4):1452-69.
- Ryff CD, Keyes CL. The structure of psychological well-being revisited. Journal of Personality and Social Psychology. 1995;69(4):719-27.
- Taylor SE, Kemeny ME, Reed GM, Bower JE, Gruenewald TL. Psychological resources, positive illusions, and health. American Psychologist. 2000;55(1):99-109.
- Thorsen SV, Rugulies R, Hjarsbech PU, Bjorner JB. The predictive value of mental health for long-term sickness absence: the Major Depression Inventory (MDI) and the Mental Health Inventory (MHI-5) compared. BMC Medical Research Methodology. 2013;13(1):1-7.
- Veit CT, Ware JE. The structure of psychological distress and well-being in general population. Journal of Consulting and Clinical Psychology. 1983;51(5):730-42.
- Heubeck BG, Neill JT. Confirmatory factor analysis and reliability of the Mental Health Inventory for Australian adolescents. Psychological Reports. 2000;87(2):431-40.
- Berwick DM, Murphy JM, Goldman PA, Ware Jr JE, Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Medical Care. 1991;169-76.
- Ware JE Jr, Gandek B. The SF-36 Health Survey: Development and use in mental health research and the IQOLA Project. International Journal of Mental Health. 1994;23:49-73.
- Holmes WC. A short, psychiatric, case-finding measure for HIV seropositive outpatients: Performance characteristics of the 5-item mental health subscale of the SF-20 in a male, seropositive sample. Medical Care. 1998;36(2):237-43.
- Rivera-Riquelme M, et al. The revised Mental Health Inventory-5 (MHI-5) as an ultra-brief screening measure of bidimensional mental health in children and adolescents. Psychiatry Research. 2019;274:247-53.
- Damasio BF, Borsa JC, Koller SH. Adaptation and psychometric properties of the Brazilian version of the Five-item Mental Health Index (MHI-5). Psicologia: Reflexão e Crítica. 2014;27(2):323-30.
- Elovanio M, et al. General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI-6), and Mental Health Index (MHI-5): Psychometric and predictive properties in a Finnish population-based sample. Psychiatry Research. 2020;289:112973.
- Nearchou F, et al. Validation and psychometric evaluation of a brief screening questionnaire for psychological distress in patients with psoriasis. Journal of the European Academy of Dermatology and Venereology. 2019;33(7):1325-30.
- Marques SC, Pais-Ribeiro JL, Lopez SJ. Use of the "Mental Health Inventory-5" with Portuguese 10-15 years old. The Spanish Journal of Psychology. 2011;14(1):478-85.
- Hoeymans N, et al. Measuring mental health of the Dutch population: A comparison of the GHQ-12 and the MHI-5. Health and Quality of Life Outcomes. 2004;2(1):23.
- Kroenke K, et al. Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine. 2007;146(5):317-25.
- Cuijpers P, Smits N, Donker T, Ten Have M, de Graaf R. Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. Psychiatry Research. 2009;163(3):250-5.
- Mitchell AJ, Coyne JC. Do ultra-short screening instrument accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies. British Journal of General Practice. 2007;57(535):144-51.
- Ware JE, Kosinski M, Dewey JE. How to score version 2 of the SF-36 Health Survey (standard & acute forms). Lincoln, RI: Quality Metric Incorporated; 2000.
- Yamazaki S, Fukuhara S, Green J. Usefulness of five-item and three-item Mental Health Inventory to screen for depressive symptoms in the general population of Japan. Health Qual Life Outcomes. 2005;3(1):48.
- Derogatis L. SCL-90-R Administration, Scoring and Procedures Manual. Towson (MD): Clinical Psychometric Research; 1983.
- Goldberg DP, Williams P. A user's guide to the General Health Questionnaire: GHQ. Windsor (UK): NFER-Nelson; 1988.
- Aulike IA, Dobson AJ, Egwunye J, Fitzgerald DM, Mishra GD. Assessing agreement between the K10 and MHI-5 measures of psychological well-being. Applied Research in Quality of Life. 2020;16(6):1753-66.
- Lara MA, et al. Validity and reliability of the MHI-5 for evaluating depression in women at the primary health care level. Salud Mental. 2002;25(6):13-20.
- Vaingankar JA, Subramaniam M, Abdin E, Picco L, Chua BY, Eng GK, et al. Development, validity and reliability of the short multidimensional positive mental health instrument. Quality of Life Research. 2014;23:1459-77.
- Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine. 2006;166:1092-7.
- Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine. 2011;16, 606-13.
- Besharat MA. Reliability and validity of the 28-item model of mental health inventory in the Iranian population. Journal of Pezeshki Ghanooni. 2009;54:87-91. [Persian].
- Stewart AL, Hays RD, Ware Jr JE. The MOS short-form general health survey: Reliability and validity in a patient population. Medical Care. 1988;724-35.
- Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Medical Care. 1992;30(6):473-83.
- Ware JE, Keller SD, Kosinski M. SF-36: Physical and mental health summary scales: A user's manual. Boston, MA: Health Assessment Lab; 1994.
- Bray I, Gunnell D. Suicide rates, life satisfaction and happiness as markers for population mental health. Social Psychiatry and Psychiatric Epidemiology. 2006;41(4):333-7.
- Bültmann U, Rugulies R, Lund T, Christensen KB, Labriola M, Burr H. Depressive symptoms and the risk of long-term sickness absence. Social Psychiatry and Psychiatric Epidemiology. 2006;41(10):875-80.
- Pais-Ribeiro JL. Mental Health Inventory: um estudo de adaptação à população portuguesa. Psicologia, Saúde e Doenças. 2001;2:77-99.
- Sullivan M, Karlsson J. The Swedish SF-36 Health Survey III. Evaluation of criterion-based validity: results from normative population. Journal of Clinical Epidemiology. 1998;51:1105–13.
- Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: Health Institute; 1993.