The factor structure of the General Health Questionnaire (GHQ): a scaled version for general practice in Spain

AbstractBackgroundThe 28-item version of the General Health Questionnaire (GHQ-28) developed by Goldberg and Hillier in 1979 is constructed on the basis of a principal components analysis of the GHQ-60. When used on a Spanish population, a translation of the GHQ-28 developed for an English population may lead to worse predictive values.MethodsWe used our Spanish sample to replicate the entire process of construction of the GHQ-28 administered in a primary-care setting.ResultsTwo shorter versions were proposed: one with six scales and 30 items, and the other with four scales and 28 items.ConclusionsThe resulting GHQ-28 was a successful adaptation for use on the Spanish sample. When compared with the original version, only 21 items were the same. Moreover, contrary to the English version, which groups sleep problems and anxiety in the same scale, a scale with items related exclusively to ‘Sleep disturbances’ was found.

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A scaled version of the General Health Questionnaire

Psychological Medicine ◽

10.1017/s0033291700021644 ◽

1979 ◽

Vol 9 (1) ◽

pp. 139-145 ◽

Cited By ~ 2873

Author(s):

D. P. Goldberg ◽

V. F. Hillier

Keyword(s):

Primary Care ◽

Factor Structure ◽

General Health ◽

Care Setting ◽

Primary Care Setting ◽

General Health Questionnaire ◽

Somatic Symptoms ◽

Severe Depression ◽

Health Questionnaire ◽

Item Questionnaire

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.

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Dimensions of neurosis

Psychological Medicine ◽

10.1017/s0033291700038575 ◽

1992 ◽

Vol 22 (4) ◽

pp. 1011-1018 ◽

Cited By ~ 13

Author(s):

Glyn Lewis

Keyword(s):

Mental Health ◽

General Health ◽

General Health Questionnaire ◽

Empirical Support ◽

General Factor ◽

Health Questionnaire ◽

Components Analysis ◽

Positive Coefficients ◽

Anxiety Depression

SynopsisFactor analyses of the General Health Questionnaire have attempted to interpret the factors as measuring anxiety, depression and social functioning. Data from two large community surveys were used to conduct an unrotated principal components analysis of the 30-item General Health Questionnaire. A general factor, indicating overall severity of psychiatric disorder, accounted for around 30% of the variance. The next most important factor, accounting for about 8% of the variance, was bipolar with the positive (‘less than usual’) items of the General Health Questionnaire having positive coefficients and the negative (‘more than usual’) items having negative coefficients. It is suggested that the concepts of positive and negative mental health derive empirical support from the results and may prove to be a useful classification of dimensions of mental health in the community.

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Form, frequency and burden of sleep problems in general health care: a report from the WHO Collaborative Study on Psychological Problems in General Health Care

European Psychiatry ◽

10.1016/0924-9338(96)80462-7 ◽

1996 ◽

Vol 11 (S1) ◽

pp. 5s-10s ◽

Cited By ~ 40

Author(s):

TB Üstün ◽

M Privett ◽

Y Lecrubier ◽

E Weiller ◽

G Simon ◽

...

Keyword(s):

Health Care ◽

General Health ◽

Sleep Problems ◽

Somatoform Disorders ◽

General Health Questionnaire ◽

Collaborative Study ◽

Alcohol Problems ◽

Psychological Problems ◽

Health Questionnaire ◽

Icd 10

SummaryThe WHO Collaborative Study on Psychological Problems in General Health Care examined the frequency, form, course and outcome of psychological problems in general health care settings. A total of 25,916 general health care attenders at 15 sites in 14 countries were screened using the 12-item General Health Questionnaire (GHQ-12). Of those screened, 5,438 were assessed in detail using a Primary Health Care version of the Composite International Diagnostic Interview (CIDI-PHC) in conjunction with the Brief Disability Questionnaire, the Social Disability Schedules, a self rated overall health status form and the 28-item General Health Questionnaire. The analysis has shown that sleep problems were common at all sites with: 26.8% of all patients having some form of sleep problem and 15% of the patients examined had trouble falling or staying asleep. Of those with sleep problems, 51.5% had a well-defined International Classification of Diseases 10th Revision (ICD-10) mental disorder (such as depression, anxiety, somatoform disorders or alcohol problems) and 48.5% of those with sleep problems for at least two weeks or more did not fulfil the criteria for any well defined ICD-10 diagnosis. Persons with sleep problems reported a degree of disability in the performance of their daily activities and social roles even when they had no symptoms of psychological disorders. When such symptoms were present the disability was significantly increased.

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Factor Analysis of the General Health Questionnaire

Psychological Reports ◽

10.2466/pr0.1994.75.2.979 ◽

1994 ◽

Vol 75 (2) ◽

pp. 979-983 ◽

Cited By ~ 1

Author(s):

Richard S. Epstein ◽

Carol S. Fullerton ◽

Robert J. Ursano

Keyword(s):

Factor Analysis ◽

Principal Components Analysis ◽

Factor Structure ◽

Principal Components ◽

General Health ◽

Depressive Symptomatology ◽

General Health Questionnaire ◽

Health Questionnaire ◽

Components Analysis ◽

Army Soldiers

We present the factor structure of the General Health Questionnaire-60 as derived from a population of 2115 Army soldiers. An eight-factor principal components analysis provided the most clinically relevant solution and explained 58.0% of the variance. We distinguished two types of depressive symptomatology, suggesting the questionnaire may be useful in differentiating shame-ridden dysphoria from anergic disinterest.

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Fatigue and psychiatric disorder: different or the same?

Psychological Medicine ◽

10.1017/s0033291799008697 ◽

1999 ◽

Vol 29 (4) ◽

pp. 863-868 ◽

Cited By ~ 43

Author(s):

G. VAN DER LINDEN ◽

T. CHALDER ◽

I. HICKIE ◽

A. KOSCHERA ◽

P. SHAM ◽

...

Keyword(s):

Primary Care ◽

General Practitioner ◽

Psychiatric Disorder ◽

Care Setting ◽

Primary Care Setting ◽

Psychiatric Symptoms ◽

General Health Questionnaire ◽

Health Questionnaire ◽

Time Points ◽

Time Point

Background. Fatigue and psychiatric symptoms are common in the community, but their association and outcome are sparsely studied.Method. A total of 1177 patients were recruited from UK primary care on attending their general practitioner. Fatigue and psychiatric disorder was measured at three time points with the 12-item General Health Questionnaire and the 11-item Fatigue Questionnaire.Results. Total scores for fatigue and psychiatric disorder did not differ between the three time points and were closely correlated (r around 0·6). The association between non-co-morbid (‘pure’) fatigue and developing psychiatric disorder 6 months later was the same as that for being well and subsequent psychiatric disorder. Similarly, having non-co-morbid psychiatric disorder did not predict having fatigue any more than being well 6 months previously. Between 13 and 15% suffered from non-co-morbid fatigue at each time point and 2·5% suffered from fatigue at two time points 6 months apart. Less than 1% of patients suffered from non-co-morbid fatigue at all three time points.Conclusions. The data are consistent with the existence of ‘pure’ independent fatigue state. However, this state is unstable and the majority (about three-quarters) of patients become well or a case of psychiatric disorder over 6 months. A persistent, independent fatigue state lasting for 6 months can be identified in the primary-care setting, but it is uncommon – of the order of 2·5%. Non-co-morbid (pure) fatigue did not predict subsequent psychiatric disorder.

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The general health questionnaire as a measure of emotional wellbeing in pregnant women

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-05-2019-0028 ◽

2019 ◽

Vol 14 (6) ◽

pp. 447-456

Author(s):

Yvonne Kuipers ◽

Julie Jomeen ◽

Tinne Dilles ◽

Bart Van Rompaey

Keyword(s):

Pregnant Women ◽

External Validity ◽

General Health ◽

Convergent Validity ◽

General Health Questionnaire ◽

Health Questionnaire ◽

Emotional Wellbeing ◽

Operating Characteristics ◽

Predictive Values ◽

Content Type

Purpose The purpose of this paper is to measure reliability, validity and accuracy of the 12-item General Health Questionnaire (GHQ-12) as a measure of emotional wellbeing in pregnant women; utility and threshold in particular. Design/methodology/approach The authors measured self-reported emotional wellbeing responses of 164 low-risk pregnant Dutch women with the GHQ-12 and a dichotomous case-finding item (Gold standard). The authors established internal consistency of the 12 GHQ-items (Cronbach’s coefficient α); construct validity: factor analysis using Oblimin rotation; convergent validity (Pearson’s correlation) and discriminatory ability (area under the receiver operating characteristics curve and index of union); and external validity of the dichotomous criterion standard against the GHQ-12 responses (sensitivity, specificity, likelihood ratios and predictive values), applying a cut-off value of ⩾ 12 and ⩾ 17, respectively. Findings A coefficient of 0.85 showed construct reliability. The GHQ-12 items in the pattern matrix showed a three-dimensional factorial model: factor 1, anxiety and depression; factor 2, coping; and factor 3, significance/effect on life, with a total variance of 59 per cent. The GHQ-12 showed good accuracy (0.84; p=<0.001) and external validity (r=0.57; p=<0.001) when the cut-off value was set at the ⩾ 17 value. Using a cut-off value of ⩾ 17 demonstrated higher sensitivity (72.32 vs 41.07 per cent) but lower specificity (32.69 vs 55.77 per cent) compared to the commonly used cut-off value of ⩾ 12. Research limitations/implications Findings generally support the reliability, validity and accuracy of the Dutch version of the GHQ-12. Further evaluation of the measure, at more than one timepoint during pregnancy, is recommended. Practical implications The GHQ-12 holds the potential to measure antenatal emotional wellbeing and women’s emotional responses and coping mechanisms with reduced antenatal emotional wellbeing. Social implications Adapting the GHQ-12 cut-off value enables effective identification of reduced emotional wellbeing to provide adequate care and allows potential reduction of anxiety among healthy pregnant women who are incorrectly screened as positive. Originality/value A novel aspect is adapting the threshold of the GHQ-12 to ⩾ 17 in antenatal care.

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THE FACTOR STRUCTURE OF THE 60 ITEM GENERAL HEALTH QUESTIONNAIRE

Social Behavior and Personality An International Journal ◽

10.2224/sbp.1986.14.2.123 ◽

1986 ◽

Vol 14 (2) ◽

pp. 123-131 ◽

Cited By ~ 3

Author(s):

Clive Layton ◽

John Rust

Keyword(s):

Factor Structure ◽

School Children ◽

Principal Components ◽

General Health ◽

General Health Questionnaire ◽

Principal Component ◽

Questionnaire Data ◽

Health Questionnaire ◽

Oblique Rotation ◽

Components Analysis

Male school children (N 241), all aged 16 years, and 144 men facing redundancy completed the 60 item version of the General Health Questionnaire. Data from the two groups was analysed separately using unrotated first principal components analysis followed by oblique rotation. The unrotated first principal component accounted for 23% of the variance in the school group, and 13.2% in the group facing redundancy. No subsequent component accounted for more than 6.1% of the variance. For both samples the first five components were subjected to an oblique rotation. Results were discussed in relation to previous findings of the GHQ. The factor structure was found to be unstable across groups. The implications of these findings were considered in the context of proposed subscales of the GHQ.

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