Psychiatric Effects of Alternate Day Steroid Therapy

SummaryThe prevalence of emotional disorder in a total of 72 patients suffering from myasthenia gravis or from peripheral neuromuscular disorders was assessed, using the General Health Questionnaire and Present State Examination.Approximately half the patients were being treated with an alternate day regime of prednisone, receiving high dosage one day and low the next. Emotional disorder was found to be less prevalent among these patients than among patients not on steroids. The significance of the finding is discussed.

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Psychiatric symptoms in self-poisoning patients

Psychological Medicine ◽

10.1017/s0033291700032049 ◽

1979 ◽

Vol 9 (3) ◽

pp. 493-500 ◽

Cited By ~ 67

Author(s):

J. G. B. Newson-Smith ◽

S. R. Hirsch

Keyword(s):

Present State ◽

General Health ◽

Psychiatric Symptoms ◽

General Health Questionnaire ◽

Health Questionnaire ◽

Initial Interview ◽

Low Prevalence ◽

State Examination

SynopsisSelf-poisoning patients admitted to hospital were studied for persistence of psychiatric symptoms over a 3-month period and evaluated at 3 points in time with the General Health Questionnaire and the Present State Examination. Symptoms were identified which had a high or low prevalence at 3-month follow-up. GHQ and PSE scores correlated at 0·8. The implications of the study are discussed, particularly the earlier need for out-patient help in those who had a moderate or high number of symptoms at initial interview.

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Polytomous logistic regression analysis of the General Health Questionnaire and the Present State Examination

Psychological Medicine ◽

10.1017/s0033291700024351 ◽

1989 ◽

Vol 19 (3) ◽

pp. 755-764 ◽

Cited By ~ 9

Author(s):

F. W. Wilmink ◽

T. A. B. Snijders

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Regression Model ◽

Present State ◽

General Health ◽

Logistic Regression Model ◽

General Health Questionnaire ◽

Health Questionnaire ◽

Polytomous Logistic Regression ◽

State Examination

SynopsisFirst, two examples of dichotomous logistic regression analysis are presented. The probability of being a psychiatric case according to the Present State Examination is predicted from the total score on the General Health Questionnaire and from the general practitioner's judgement on the presence of a mental health problem. Subjects were 292 primary care attenders. Results are compared with those from prior studies.Next, the extension to the polytomous case is demonstrated. The probability of being at any given level of the Index of Definition (computed from PSE data) is estimated from the General Health Questionnaire total score by an ordered polytomous logistic regression model. Several applications of the polytomous logistic regression model are discussed. These range from estimating the proportion of psychiatric cases among individuals who refuse to be interviewed to the formulation of sampling schemes which can be expected to reduce costs while at the same time yielding optimal information for testing specific hypotheses.

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Validation of the General Health Questionnaire in a young community sample

Psychological Medicine ◽

10.1017/s0033291700050972 ◽

1983 ◽

Vol 13 (2) ◽

pp. 349-353 ◽

Cited By ~ 251

Author(s):

Michael H. Banks

Keyword(s):

General Health ◽

Community Sample ◽

General Health Questionnaire ◽

Continuous Variable ◽

General Factor ◽

Health Questionnaire ◽

Relative Independence ◽

The Social ◽

Misclassification Rates ◽

State Examination

SYNOPSISValidity coefficients of the 30-item, 28-item and 12-item versions of the General Health Questionnaire (GHQ) were determined by comparison with the Present State Examination (PSE) in a sample of 200 17-year-olds. The PSE classified 7 people (3·5%) as cases, although only 47% were identified as free of symptoms. Misclassification rates, sensitivity and specificity values are presented for different cutting scores for the three versions of the GHQ. The GHQ-28 had superior values, especially with a cutting score of 5/6; the GHQ-12 with a 2/3 cutting score also had acceptable values. All versions of the GHQ correlated highly with the PSE Index of Definition and total scores, providing support for the treatment of GHQ scores as a continuous variable in this kind of population. Correlations between sub-scales of the GHQ-28 give further evidence for a general factor and the relative independence of the social dysfunction sub-scale.

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Severity of Psychiatric Disorder and the 30-Item General Health Questionnaire

The British Journal of Psychiatry ◽

10.1192/bjp.134.6.609 ◽

1979 ◽

Vol 134 (6) ◽

pp. 609-616 ◽

Cited By ~ 121

Author(s):

Robert A. Finlay-Jones ◽

Elaine Murphy

Keyword(s):

Psychiatric Disorder ◽

General Health ◽

General Health Questionnaire ◽

Health Questionnaire ◽

False Negatives ◽

Two Samples ◽

Threshold Score ◽

Adverse Life Event ◽

Chronic Disorders ◽

State Examination

SummaryThe 30-item General Health Questionnaire misclassified 26 per cent of respondents in two samples of women who were interviewed by a psychiatrist using the Present State Examination. False negatives were likely to be women with chronic disorders, particularly anxiety states. False positives were likely to be distressed by severe physical illness, a recent adverse life event, or loneliness. Applying a higher threshold score to their GHQ, responses would help to separate those with a diagnosable psychiatric disorder from those in states of distress.

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Detecting psychiatric disorders in medical practice using the General Health Questionnaire. Why do cut-off scores vary?

Psychological Medicine ◽

10.1017/s003329170002818x ◽

1995 ◽

Vol 25 (1) ◽

pp. 165-170 ◽

Cited By ~ 28

Author(s):

A. M. Van Hemert ◽

M. Den Heijer ◽

M. Vorstenbosch ◽

J. H. Bolk

Keyword(s):

Psychiatric Disorders ◽

Sensitivity And Specificity ◽

Medical Practice ◽

General Health ◽

Roc Analysis ◽

General Health Questionnaire ◽

Area Under The Curve ◽

Health Questionnaire ◽

State Examination ◽

Discriminatory Capacity

SynopsisIn this study we assessed the accuracy of the General Health Questionnaire in detecting psychiatric disorders in general medical out-patients. A total of 290 newly referred patients were interviewed with the Present State Examination. Prior to the interview, 112 patients completed the full GHQ-60, 100 completed the GHQ-30 and 78 completed the GHQ-12. Data from the first group were used to study the full GHQ-60, together with the GHQ-30 and and GHQ-12, when disembedded from the full questionnaire. In a comparison between the disembedded and the separate versions of the GHQ-30 and GHQ-12 we observed considerable variation in the cut-off scores where a certain sensitivity and specificity was attained. In ROC-analysis, the versions were not materially different in their discriminatory capacity (area under the curve). The use of different criteria to define a ‘case’ demonstrated that case severity was another source of increasing cut-off scores. Our data demonstrate that the use of disembedded or separate versions of the questionnaire, together with variation in the case criteria can be a major explanation for variation in cut-off scores that was observed in previous studies.

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Emotional disorder and its assessment within the severe head injured population

Psychological Medicine ◽

10.1017/s0033291700001884 ◽

1988 ◽

Vol 18 (1) ◽

pp. 57-63 ◽

Cited By ~ 72

Author(s):

Glynda Kinsella ◽

Carmel Moran ◽

Bruce Ford ◽

Jennie Ponsford

Keyword(s):

General Health ◽

General Health Questionnaire ◽

Emotional Disorder ◽

Self Report ◽

Depression And Anxiety ◽

Health Questionnaire ◽

Head Injured ◽

Injured Population ◽

Emotional Disposition ◽

Analogue Scales

SynopsisThis study examined the usefulness of self-report measures of emotional disorder in a relatively acute, severely head injured population (i.e. individuals who had sustained their injuries cwithin the previous two years). The General Health Questionnaire, the Leeds Scales of Depression and Anxiety, and Visual Analogue Scales of Depression and Anxiety were administered to 39 severely head injured subjects and 35 ‘close others’ who were required to give their opinions on how they thought the head injured subjects were feeling. Twenty head injured subjects were re-tested within a week. Results indicated that the head injured are able to reliably complete self-report scales as indicated by the ‘close’ others similar reports. The head injured seem to be relatively aware of their overt behaviours and emotions, at least when utilizing the General Health Questionnaire and the Leeds Scale of Depression. According to the measures of emotional disposition used in the present study, emotional disorder was found to be common. From the results it was further suggested that lack of a close confiding relationship predicts emotional disorder and may be used to identify those subjects at risk. Overall, the results provide confidence for the use of self-report scales as a preliminary approach to the identification of emotional disorder in the severely head injured.

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