Abstract
Background
Perimenopausal depression poses a significant public health challenge in China, yet the absence of a culturally validated, condition-specific screening tool contributes to substantial underdiagnosis. Given the cultural tendency for Chinese patients to express psychological distress via somatic complaints, we hypothesized that the factor structure of the Meno-D in a Chinese sample would diverge from its original Western five-factor model. Accordingly, this study conducted the first cross-cultural adaptation and psychometric validation of the scale in this population.Methods
Following Brislin's translation framework, the 12-item Meno-D was translated and adapted through expert review and cognitive debriefing. A total of 357 eligible perimenopausal women (mean age: 50.460 ± 3.156 years, range 45-55; 44.8% urban, 20.4% town, 34.7% rural) were recruited from gynecological outpatient clinics and randomly split into subsamples for exploratory (n = 157) and confirmatory (n = 200) factor analyses. Content, construct, convergent, discriminant and concurrent validity (with the PHQ-9 as reference scale), internal consistency, split-half reliability and two-week test-retest reliability were comprehensively evaluated. Acceptable model fit thresholds were defined as χ²/df Results
Exploratory factor analysis revealed a two-factor structure (Somatic-Physiological and Emotional-Cognitive Symptoms), which demonstrated superior fit (χ²/df = 2.042, RMSEA = 0.072, CFI = 0.962) compared to the original five-factor model (χ²/df = 4.611, RMSEA = 0.135, CFI = 0.890). The scale showed acceptable convergent validity (AVE = 0.566-0.679; CR = 0.901-0.914), discriminant validity (inter-factor r = 0.338), and strong concurrent validity with the PHQ-9 (r = 0.760, p Conclusion
This study provides preliminary psychometric evidence for the Chinese version of the Meno-D, demonstrating satisfactory reliability and construct validity in a sample of perimenopausal women. However, several methodological constraints must be acknowledged. Data were collected from a single-center clinical convenience sample, and women receiving antidepressants or hormone replacement therapy were excluded. Furthermore, diagnostic accuracy validated against structured clinical interviews has not yet been established, and clinically meaningful cutoff scores remain unavailable. These limitations restrict the generalizability and clinical applicability of the present findings. Accordingly, the Chinese Meno-D is not yet ready for routine clinical screening. Its true clinical utility remains to be determined through future multicenter prospective validation studies, which should incorporate structured diagnostic interviews, recruit community-dwelling populations and pharmacologically treated subgroups, and establish empirically derived cutoff values to clarify the scale's role in clinical practice.