A Multinational Comparison Study of the Patient-Reported Outcomes Measurement Information System Anxiety, Depression, and Anger Item Bank in the General Population

Int J Methods Psychiatr Res. 2025 Mar;34(1):e70012. doi: 10.1002/mpr.70012.

Abstract

Objectives: This study aimed to compared Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety, depression, and anger item bank among Korean, US and Dutch general population.

Methods: Between December 2021 and January 2022, we surveyed representative Korean participants (N = 2699). Then we compared the mean T-scores of PROMIS anxiety, depression, and anger full items bank among Korean, US (N = 1696) and the Dutch (N = 1002) populations. Differential item-functioning (DIF) analyses were also performed. We also compared each score by age group, sex, presence of comorbidities, and general health status.

Results: In Korean, the mean T-scores for anxiety, depression, and anger were 45.3 (standard deviation [SD] = 11.6), 48.4 (SD = 11.2), and 44.9 (SD = 12.6), respectively. Among the general population in Korea, patients aged 35-44 years and those with comorbidities had higher anxiety, depression, and anger scores. In the DIF analyses between the US and Korean populations, 28%, 32%, and 45% were flagged for uniform or non-uniform DIF in anxiety, depression and anger, respectively.

Conclusions: Considering the cultural differences, we recommend using a harmonized approach that includes country-specific reference values while retaining a standardized core set of items to enable cross-country comparability.

Keywords: PROMIS; emotional distress; general population; patient‐reported outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anger* / physiology
  • Anxiety* / diagnosis
  • Anxiety* / epidemiology
  • Cross-Cultural Comparison
  • Depression* / diagnosis
  • Depression* / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Patient Reported Outcome Measures*
  • Republic of Korea / epidemiology
  • United States / epidemiology
  • Young Adult