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Discriminant validity of the 12-item version of the general health questionnaire in a Swedish case-control study
Karolinska Institutet / Stockholm County Council.
Karolinska Institutet.
Stockholm County Council.
Karolinska Institutet / Stockholm County Council.
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2017 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 71, no 3, p. 171-179Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The 12-item version of the General Health Questionnaire (GHQ-12) is widely used as a proxy for Affective Disorders in public health surveys, although the cut-off points for distress vary considerably between studies. The agreement between the GHQ-12 score and having a clinical disorder in the study population is usually unknown.

AIMS: This study aimed to assess the criterion validity and to determine the sensitivity and specificity of the GHQ-12 in the Swedish population.

METHODS: This study used 556 patient cases surveyed in specialized psychiatric care outpatient age- and sex-matched with 556 controls from the Stockholm Health Survey. Criterion validity for two scoring methods of GHQ-12 was tested using Receiver Operating Characteristics (ROC) analyses with Area Under the Curve (AUC) as a measure of agreement. Reference standard was (1) specialized psychiatric care and (2) current depression, anxiety or adjustment disorder.

RESULTS: Both the Likert and Standard GHQ-12 scoring method discriminated excellently between individuals using specialized psychiatric services and healthy controls (Likert index AUC = 0.86, GHQ index AUC = 0.83), and between individuals with current disorder from healthy controls (Likert index AUC = 0.90, GHQ index AUC = 0.88). The best cut-off point for the GHQ index was ≥4 (sensitivity = 81.7 and specificity = 85.4), and for the Likert index ≥14 (sensitivity = 85.5 and specificity = 83.2).

CONCLUSIONS: The GHQ-12 has excellent discriminant validity and is well suited as a non-specific measure of affective disorders in public mental health surveys.

Place, publisher, year, edition, pages
2017. Vol. 71, no 3, p. 171-179
Keyword [en]
GHQ, Sensitivity and specificity, affective disorder, area under the curve, screening, self-assessment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-2515DOI: 10.1080/08039488.2016.1246608PubMedID: 27796153OAI: oai:DiVA.org:rkh-2515DiVA, id: diva2:1166626
Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2017-12-15Bibliographically approved

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Tinghög, PetterSaboonchi, Fredrik

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