Diagnosing mental disorders in primary care: the General Health Questionnaire (GHQ) and the Symptom Check List (SCL-90-R) as screening instruments

1999 ◽  
Vol 34 (7) ◽  
pp. 360-366 ◽  
Author(s):  
N. Schmitz ◽  
J. Kruse ◽  
C. Heckrath ◽  
L. Alberti ◽  
W. Tress
2007 ◽  
Vol 38 (2) ◽  
pp. 221-228 ◽  
Author(s):  
V. Patel ◽  
R. Araya ◽  
N. Chowdhary ◽  
M. King ◽  
B. Kirkwood ◽  
...  

BackgroundScreening of patients for common mental disorders (CMDs) is needed in primary-care management programmes. This study aimed to compare the screening properties of five widely used questionnaires.MethodAdult attenders in five primary-care settings in India were recruited through systematic sampling. Four questionnaires were administered, in pairs, in random order to participants: the General Health Questionnaire (GHQ, 12 items); the Primary Health Questionnaire (PHQ, nine items); the Kessler Psychological Distress Scale (K10, 10 items), and from which we could extract the score of the shorter 6-item K6; and the Self-Reporting Questionnaire (SRQ, 20 items). All participants were interviewed with a structured lay diagnostic interview, the Revised Clinical Interview Schedule (CIS-R).ResultsComplete data were available for 598 participants (participation rate 99.3%). All five questionnaires showed moderate to high discriminating ability; the GHQ and SRQ showed the best results. All five showed moderate to high degrees of correlation with one another, the poorest being between the two shortest questionnaires, K6 and PHQ. All five had relatively good internal consistency. However, the positive predictive value (PPV) of the questionnaires compared with the diagnostic interview ranged from 51% to 77% at the optimal cut-off scores.ConclusionsThere is little difference in the ability of these questionnaires to identify cases accurately, but none showed high PPVs without a considerable compromise on sensitivity. Hence, the choice of an optimum cut-off score that yields the best balance between sensitivity and PPV may need to be tailored to individual settings, with a higher cut-off being recommended in resource-limited primary-care settings.


2019 ◽  
Vol 7 (16) ◽  
pp. 2647-2651
Author(s):  
Lidya De Vega ◽  
Elmeida Effendy ◽  
Vita Camellia

BACKGROUND: Mental disorders are the most common problems in the life of People Living with HIV/AIDS (PLWHA). The frequency in which HIV/AIDS and mental health problems co-exist, and the complex bi-directional relationship between them. Several biological, distress psychological and social dysfunction factors are associated with mental disorders in PLWHA. AIM: To analyse the relationship between the screening of mental disorders using General Health Questionnaire-12 scores and CD4 counts of People Living with HIV/AIDS with Anti-Retroviral Treatment. METHODS: This was a correlative analytical study with a cross-sectional approach using the General Health Questionnaire-12 (GHQ-12) instrument to assess screening mental disorders and the CD4 count. This research was conducted in February 2019 – April 2019 at an HIV/AIDS outpatient clinic. As many 33 subjects were divided into inclusion criteria; participant confirmed HIV seropositivity in stage II or III were undergoing ARV treatment, ranged in age between 25-49 years. The duration of HIV disease was ≤ four years, and the duration of ARV treatment was ≥ six months and informed consent to participate in the study. The patient who had mental disorders and currently drugs user was excluded from this study. RESULTS: There was an association found between change in CD4 and screening mental disorders at univariate analysis among the study participants, whether on antiretroviral treatment. The correlation between the total GHQ-12 scores as a screening of mental disorders and CD4 counts indicated to result in a significant negative correlation, r = -0.670 with p = 0.001. CONCLUSION: Screening mental disorders using General Health Questionnaire-12 from the results of this study shows that it is important to do for PLWHA because with low CD4 levels as biomarkers the progression of HIV infection affects psychological distress and social dysfunction in people living with HIV who have the potential for symptoms of mental disorders.


1979 ◽  
Vol 9 (1) ◽  
pp. 139-145 ◽  
Author(s):  
D. P. Goldberg ◽  
V. F. Hillier

SYNOPSISThis study reports the factor structure of the symptoms comprising the General Health Questionnaire when it is completed in a primary care setting. A shorter, 28-item GHQ is proposed consisting of 4 subscales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. Preliminary data concerning the validity of these scales are presented, and the performance of the whole 28-item questionnaire as a screening test is evaluated. The factor structure of the symptomatology is found to be very similar for 3 independent sets of data.


1996 ◽  
Vol 5 (3) ◽  
pp. 172-177
Author(s):  
Richard Gater

RIASSUNTOScopo - Indagare la forma, la frequenza, la gestione e l'esito dei disturbi psichici comuni in pazienti della medicina generale. Disegno - Campionamento a due-stadi di coloro che si rivolgono ai servizi di medicina generale seguito da una valutazione longitudinale a 3 e 12 mesi dello stato mentale, della disabilità e del trattamento, eseguiti utilizzando gli stessi metodi in 15 Centri nel mondo, sotto il coordinamento dell'Organizzazione Mondiale della Sanita. Principali misure utilizzate - General Health Questionnaire, la versione per la medicina generale della Composite International Diagnostic Interview utilizzata per ricavare diagnosi secondo i criteri dell'ICD-10, la Groningen Social Disability Schedule, ed una valutazione da parte del medico di medicina generale dell'attuale stato fisico e mentale insieme ad un riassunto della loro gestione del caso. Risultati - Sono stati sottoposti a screening 25.916 pazienti e sono stati sottoposti a dettagliate interviste 5.438 pazienti. I disturbi psichici tra i pazienti degli ambulatori di medicina generale sono risultati frequenti (in media il 24% di pazienti visti consecutivamente, range 7.3%-52.5%). La disabilità è risultata più elevata nei pazienti con disturbi psichici: quanto più gravi erano i disturbi psichici, tanto pià grave era la disabilità. Il problema principale lamentato dai pazienti era spesso un sintomo somatico, mentre solo una minoranza di essi lamentava un chiaro sintomo psichico. Il riconoscimento dei disturbi da parte dei medici è risultato essere molto diverso tra i diversi Centri e in tutti i Centri metà dei casi ICD-10 non è stata identificata dai medici. I medici operand nell'area di Verona hanno messo in evidenza una particolare distorsione nei riguardi dei disturbi psichici. Un trattamento e stato prescritto a quasi tutti i pazienti che secondo i medici presentavano disturbi psichici, per cui i trattamenti sono risultati simili, indipendentemente dalla diagnosi. Conclusioni - La frequenza dei disturbi psichici nel setting della medicina generale e la disabilità ad essi associata sottolineano la loro importanza per la salute pubblica. Questi sono pazienti che si rivolgono agli ambulatori di medicina generale; la maggior parte di essi continua ad essere trattata in tale setting senza ricorrere ai servizi psichiatrici specialistici. È pertanto importante potenziare il training per il riconoscimento, la diagnosi ed il trattamento dei disturbi psichici comuni sia nelle Facolta di medicina che nei corsi di formazione dei medici di medicina generale.


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