The WHO-5 Well-Being Index: A Validation Study in People with Infertility

Background: Infertility is a public health problem and can lead to depressive symptoms. In recent years, the WHO-five Well-being Index (WHO-5) has been used as a screening measure for depression, but study on psy-chometric properties in people with infertility is scarce. The objective of this study was to examine the reliability and validity of the Persian version of the WHO-5 in people with infertility. Methods: Overall, 539 infertile patients from a referral infertility center in Tehran, Iran in the period between May and Aug 2017, completed the WHO-5, along with other psychological measures: the Patient Health Ques-tionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS). Construct validity and internal consistency of WHO-5 were evaluated using confirmatory factor analysis (CFA) and Cronbach’s alpha, respec-tively. Convergent validity was examined by relationship with PHQ-9 and HADS. Results: The prevalence of poor well-being was 44.3% and that of depression was 18.6%. CFA confirmed the unidimensional factor structure of the WHO-5. Internal consistency of the WHO-5 was good (Cronbach’s al-pha=0.858). The WHO-5 significantly correlated with the PHQ-9 (r=-0.522), HADS-anxiety (r=-0.524) and HADS-depression (r=-0.630), confirming convergent validity. Conclusion: The WHO-5 is a short and easy to use questionnaire with satisfactory reliability and validity that appears suitable for use as a screening test for depressive symptom in infertile people. In addition, the preva-lence of depression and poor well-being was very high in this population.