General Health Questionnaire
Purposeused to identify common psychiatric conditions

The General Health Questionnaire (GHQ) is a psychometric screening tool to identify common psychiatric conditions.[1] It has been translated and validated in at least two languages in addition to English, including Spanish[2] and Persian.[3] The latter used in different fields and generations.[4] Also, using GHQ was beneficial in high-tech systems personnel.[5]

The questionnaire comprises a number of questions, each with a four-point Likert scale for responses. There are versions with 12, 28, 30 and 60 questions. It is considered valid for use on adults and adolescents, but not children, and is available for purchase.[6]

Scoring

The questions in the GHQ have the response choices of Better/Healthier than Normal, Same as Usual, Worse/More than Usual, and Much Worse/More than Usual.[7][8] These responses can be scored using the Likert or GHQ scale.[8] Using the Likert scale the response choices are given the values 0, 1, 2, and 3 respectively.[7][8] When a participant completes the questionnaire the values of their responses are then summed to give a final score between 0 and 180. Using the GHQ scale, the response choices are given values of 0, 0, 1, and 1 respectively.[7][8] In this case, the final score can range from 0 to 60. Medical professionals establish score ranges that indicate the severity of any psychiatric issues. The questions can also be broken into sections that target specific psychiatric issues such as anxiety disorder, depression, and bipolar disorder. These sections can be scored individually as well, to determine the severity.[8] The score ranges used to distinguish between different severities of psychiatric issues are established by each medical professional, so there is no widely accepted set range.

History

The original study that proposed the GHQ was published in 1970 by David Goldberg and Dr. Blackwell.[9] This study was originally completed to validate the General Health Questionnaire as a reliable determinant of psychiatric health in general practice.[9][10][11] The GHQ was given to 3000 patients at a general medicine practice in London.[9] After completing the questionnaire the patients were then evaluated by a general practitioner and psychiatrist.[9] The practitioner and psychiatrist’s diagnoses were rated 0 to 4 and the questionnaire scores were categorized A-H.[9] The results of the GHQ were then compared to the general practitioner and psychiatrist’s determinations and it was found that only 8.5% of patients were miscategorized.[9] The high accuracy of the questionnaire proved that it was equivalent to a psychiatrist’s or practitioner’s diagnosis and could be used as a method of evaluating patients.[9][11][12][13]

Diagnosis Categorization System
Practitioner/Psychiatrist Score Definition
0 No psychiatric disturbance detected
1 Mild subclinical emotional disturbance detected
2 Clinically significant psychiatric illness-mild
3 Psychiatric illness-moderate
4 Psychiatric illness-marked
GHQ Score Categorization System
GHQ Score Category Definition
A Entirely physical complaints
B Physical condition in a neurotic personality
C Physical illness with associated psychiatric disturbance
D Psychiatric illness with somatic symptoms
E Unrelated physical and psychiatric illness
F Entirely psychiatric illness
G Miscellaneous, not ill, unclassifiable
H Parents of sick children

References

  1. ↑ Goldberg, David; Hillier, Valerie (1979). "A scaled version of the General Health Questionnaire". Psychological Medicine. Cambridge Univ Press. 9 (1): 139–145. doi:10.1017/s0033291700021644. PMID 424481. S2CID 46732312.
  2. ↑ Lobo, Antonio; Pérez-Echeverría, Maria; Artal, Jesus (1986). "Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population". Psychological Medicine. 16 (1): 135–140. doi:10.1017/s0033291700002579. PMID 3961039. S2CID 40608387.
  3. ↑ Montazeri, Ali; Harirchi, Amir; Artal, Jesus; Shariati, Mohammad; Garmaroudi, Gholamreza; Ebadi, Mehdi; Fateh, Abolfazl (2003). "The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version". Health and Quality of Life Outcomes. BioMed Central Ltd. 1 (1): 66. doi:10.1186/1477-7525-1-66. PMC 280704. PMID 14614778.
  4. ↑ Assadi, SM; Nakhaei, MR; Najafi, F; Fazel, S (January 2007). "Mental health in three generations of Iranian medical students and doctors. A cross-sectional study". Social Psychiatry and Psychiatric Epidemiology. 42 (1): 57–60. doi:10.1007/s00127-006-0130-7. PMID 17080322. S2CID 40701780.
  5. ↑ Arghami, Sh; Nasl Seraji, J.; Mohammad, K.; Zamani, G.; Farhangi, A.; van Vuuren, W. (2005). "Mental health in high-tech system" (PDF). Iranian Journal of Public Health: 31–37.
  6. ↑ General Health Questionnaire
  7. 1 2 3 "General Health Questionnaire (GHQ) – MHPSS Knowledge Hub". Retrieved 2023-12-01.
  8. 1 2 3 4 5 Malt, U. F.; Mogstad, T. E.; Refnin, I. B. (1989-05-10). "[Goldberg's General Health Questionnaire]". Tidsskrift for den Norske Laegeforening: Tidsskrift for Praktisk Medicin, NY Raekke. 109 (13): 1391–1394. ISSN 0029-2001. PMID 2749623.
  9. 1 2 3 4 5 6 7 Goldberg, D. P.; Blackwell, B. (1970-05-23). "Psychiatric Illness in General Practice: A Detailed Study Using a New Method of Case Identification". BMJ. 2 (5707): 439–443. doi:10.1136/bmj.2.5707.439. ISSN 0959-8138. PMC 1700485. PMID 5420206.
  10. ↑ Jackson, C. (2006-08-23). "The General Health Questionnaire". Occupational Medicine. 57 (1): 79. doi:10.1093/occmed/kql169. ISSN 0962-7480.
  11. 1 2 Carvalho, Hudson Wander de; Patrick, Christopher J.; Jorge, Miguel Roberto; Andreoli, Sérgio Baxter (March 2011). "Validation of the structural coherency of the General Health Questionnaire". Revista Brasileira de Psiquiatria. 33 (1): 59–63. doi:10.1590/S1516-44462011000100012. ISSN 1516-4446. PMID 21537722. S2CID 3520063.
  12. ↑ Goldberg, D. P.; Gater, R.; Sartorius, N.; Ustun, T. B.; Piccinelli, M.; Gureje, O.; Rutter, C. (January 1997). "The validity of two versions of the GHQ in the WHO study of mental illness in general health care". Psychological Medicine. 27 (1): 191–197. doi:10.1017/S0033291796004242. ISSN 0033-2917. PMID 9122299. S2CID 7842411.
  13. ↑ Hankins, Matthew (December 2008). "The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions". BMC Public Health. 8 (1): 355. doi:10.1186/1471-2458-8-355. ISSN 1471-2458. PMC 2572064. PMID 18854015.
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