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After translation and cultural adaptation, item 4 and item 11 were removed due to cultural and gender-specific considerations and limited psychometric performance, resulting in a 13-item version. Factor structure was examined using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Measurement invariance across gender and age groups was evaluated using multi-group CFA. Internal consistency was assessed using McDonald\u2019s omega. An exploratory network analysis (EBICglasso) examined conditional associations among symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both a unidimensional CFA model (CFI = 0.988, RMSEA = 0.054) and a three-factor ESEM model (CFI = 0.992, RMSEA = 0.046) showed good model fit, with the ESEM structure providing a more differentiated representation of pain\/fatigue, gastrointestinal, and cardiopulmonary domains. Measurement invariance testing supported full scalar invariance across gender, while partial metric invariance was observed across age groups. Internal consistency was acceptable (\u03c9\u2009=\u20090.70\u20130.83). Network estimates demonstrated acceptable stability, with correlation stability coefficients of 0.59 for edge strength and 0.52 for bridge strength, and should be interpreted as exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The culturally adapted 13-item Kurdish PHQ demonstrates acceptable reliability and initial evidence of construct validity in trauma-exposed survivors of chemical attacks. The instrument may be used as a screening tool for somatic symptom burden in this context, while further validation in broader Kurdish populations is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12888-026-08020-1","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:44:30Z","timestamp":1774946670000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reliability and validity of the Kurdish version of the patient health questionnaire-15 in a trauma-affected population"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1185-3995","authenticated-orcid":false,"given":"Ibrahim","family":"Mohammed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6816-8859","authenticated-orcid":false,"given":"Hataw Ahmed","family":"Sharif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2925-101X","authenticated-orcid":false,"given":"Jan","family":"Kizilhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1569-0985","authenticated-orcid":false,"given":"Bushra","family":"Hasin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9366-8728","authenticated-orcid":false,"given":"Sergi","family":"Papiol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Ruebekeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7135-762X","authenticated-orcid":false,"given":"Urs","family":"Heilbronner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6624-2975","authenticated-orcid":false,"given":"Thomas G.","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-2602","authenticated-orcid":false,"given":"Martin","family":"Hautzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"issue":"9","key":"8020_CR1","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1007\/s00127-006-0082-y","volume":"41","author":"W Hiller","year":"2006","unstructured":"Hiller W, Rief W, Br\u00e4hler E. 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AIDS Care. 2024;36(9):1350\u20137. https:\/\/doi.org\/10.1080\/09540121.2024.2361829.","journal-title":"AIDS Care"}],"container-title":["BMC Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12888-026-08020-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-026-08020-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-026-08020-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:13:50Z","timestamp":1781644430000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12888-026-08020-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8020"],"URL":"https:\/\/doi.org\/10.1186\/s12888-026-08020-1","relation":{},"ISSN":["1471-244X"],"issn-type":[{"value":"1471-244X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]},"assertion":[{"value":"6 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received ethical approval from the University of Duhok, ethics committee on October 3rd, 2021 (approval number: 141). In addition, permission was obtained from the Halabja governorate in April 2022 (reference number: 10\/158), including the general directorates of security and police.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Written informed consent was obtained from all participants prior to data collection. Participation was completely voluntary, confidentiality was ensured, and participants were informed of their right to withdraw from the study at any time without consequences. For participants not able to read or write, the consent form was read aloud, and informed consent was obtained using a thumbprint in the presence of a witness.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent procedure"}},{"value":"The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical guidelines"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"293"}}