General Health Questionnaire

{{Short description|Psychometric screening tool}}

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| purpose =used to identify common psychiatric conditions

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The General Health Questionnaire (GHQ) is a psychometric screening tool to identify common psychiatric conditions.{{cite journal|last1=Goldberg|first1=David|last2=Hillier|first2=Valerie|title=A scaled version of the General Health Questionnaire|journal=Psychological Medicine|date=1979|volume=9|number=1|pages=139–145|publisher=Cambridge Univ Press |pmid=424481 |doi=10.1017/s0033291700021644|s2cid=46732312 }}

It has been translated and validated in at least two languages in addition to English, including Spanish{{cite journal|last1=Lobo|first1=Antonio|last2=Pérez-Echeverría

|first2=Maria|last3=Artal|first3=Jesus|title=Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population|journal=Psychological Medicine |date=1986|volume=16|number=1|pages=135–140 |pmid=3961039 |doi=10.1017/s0033291700002579|s2cid=40608387 }} and Persian.{{cite journal|

last1=Montazeri|first1=Ali|author1-link= Ali Montazeri |last2=Harirchi|first2=Amir|last3=Artal|first3=Jesus|

last4=Shariati|first4=Mohammad|last5=Garmaroudi|first5=Gholamreza|last6=Ebadi|first6=Mehdi|last7=Fateh|first7=Abolfazl |title=The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version|journal=Health and Quality of Life Outcomes|

date=2003|volume=1|number=1|page=66|publisher=BioMed Central Ltd|doi=10.1186/1477-7525-1-66 |doi-access=free |pmid=14614778|pmc=280704}} The latter used in different fields and generations.{{cite journal |last1=Assadi |first1=SM |last2=Nakhaei |first2=MR |last3=Najafi |first3=F |last4=Fazel |first4=S |title=Mental health in three generations of Iranian medical students and doctors. A cross-sectional study. |journal=Social Psychiatry and Psychiatric Epidemiology |date=January 2007 |volume=42 |issue=1 |pages=57–60 |doi=10.1007/s00127-006-0130-7 |pmid=17080322|s2cid=40701780 }} Also, using GHQ was beneficial in high-tech systems personnel.{{Cite journal|last1= Arghami |first1=Sh |last2=Nasl Seraji |first2=J. |last3=Mohammad |first3=K. |last4=Zamani |first4=G. |last5=Farhangi |first5=A. |last6=van Vuuren |first6=W. |date=2005|title= Mental health in high-tech system |journal= Iranian Journal of Public Health |pages=31–37 |url=https://core.ac.uk/download/pdf/287635162.pdf}}

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.{{Cite web |url=http://knowledgex.camh.net/amhspecialists/Screening_Assessment/screening/screen_CD_youth/Pages/GHQ.aspx |title=General Health Questionnaire |access-date=2015-08-15 |archive-date=2015-08-16 |archive-url=https://web.archive.org/web/20150816052825/http://knowledgex.camh.net/amhspecialists/Screening_Assessment/screening/screen_CD_youth/Pages/GHQ.aspx |url-status=dead }}

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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.{{Cite web |title=General Health Questionnaire (GHQ) – MHPSS Knowledge Hub |url=https://mhpssknowledgehub.sph.cuny.edu/measures/general-health-questionnaire-ghq/ |access-date=2023-12-01 |language=en-US}}{{Cite journal |last1=Malt |first1=U. F. |last2=Mogstad |first2=T. E. |last3=Refnin |first3=I. B. |date=1989-05-10 |title=[Goldberg's General Health Questionnaire] |url=https://pubmed.ncbi.nlm.nih.gov/2749623 |journal=Tidsskrift for den Norske Laegeforening: Tidsskrift for Praktisk Medicin, NY Raekke |volume=109 |issue=13 |pages=1391–1394 |issn=0029-2001 |pmid=2749623}} These responses can be scored using the Likert or GHQ scale. Using the Likert scale the response choices are given the values 0, 1, 2, and 3 respectively. 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. 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. 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.{{cn|date=March 2024}}

History

The original study that proposed the GHQ was published in 1970 by David Goldberg and Dr. Blackwell.{{Cite journal |last1=Goldberg |first1=D. P. |last2=Blackwell |first2=B. |date=1970-05-23 |title=Psychiatric Illness in General Practice: A Detailed Study Using a New Method of Case Identification |url=http://dx.doi.org/10.1136/bmj.2.5707.439 |journal=BMJ |volume=2 |issue=5707 |pages=439–443 |doi=10.1136/bmj.2.5707.439 |pmid=5420206 |pmc=1700485 |issn=0959-8138}} This study was originally completed to validate the General Health Questionnaire as a reliable determinant of psychiatric health in general practice.{{Cite journal |last=Jackson |first=C. |date=2006-08-23 |title=The General Health Questionnaire |url=https://academic.oup.com/occmed/article-lookup/doi/10.1093/occmed/kql169 |journal=Occupational Medicine |language=en |volume=57 |issue=1 |pages=79 |doi=10.1093/occmed/kql169 |issn=0962-7480}}{{Cite journal |last1=Carvalho |first1=Hudson Wander de |last2=Patrick |first2=Christopher J. |last3=Jorge |first3=Miguel Roberto |last4=Andreoli |first4=Sérgio Baxter |date=March 2011 |title=Validation of the structural coherency of the General Health Questionnaire |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462011000100012&lng=en&tlng=en |journal=Revista Brasileira de Psiquiatria |volume=33 |issue=1 |pages=59–63 |doi=10.1590/S1516-44462011000100012 |pmid=21537722 |s2cid=3520063 |issn=1516-4446|doi-access=free }} The GHQ was given to 3000 patients at a general medicine practice in London. After completing the questionnaire the patients were then evaluated by a general practitioner and psychiatrist. The practitioner and psychiatrist's diagnoses were rated 0 to 4 and the questionnaire scores were categorized A-H. 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. 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.{{Cite journal |last1=Goldberg |first1=D. P. |last2=Gater |first2=R. |last3=Sartorius |first3=N. |last4=Ustun |first4=T. B. |last5=Piccinelli |first5=M. |last6=Gureje |first6=O. |last7=Rutter |first7=C. |date=January 1997 |title=The validity of two versions of the GHQ in the WHO study of mental illness in general health care |url=https://www.cambridge.org/core/product/identifier/S0033291796004242/type/journal_article |journal=Psychological Medicine |language=en |volume=27 |issue=1 |pages=191–197 |doi=10.1017/S0033291796004242 |pmid=9122299 |s2cid=7842411 |issn=0033-2917}}{{Cite journal |last=Hankins |first=Matthew |date=December 2008 |title=The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions |journal=BMC Public Health |language=en |volume=8 |issue=1 |page=355 |doi=10.1186/1471-2458-8-355 |issn=1471-2458 |pmc=2572064 |pmid=18854015 |doi-access=free }}

class="wikitable"

|+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

class="wikitable"

|+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