28-Item General Health Questionnaire

Objective[edit | edit source]

The General Health Questionnaire (GHQ) is a screening device for identifying minor psychiatric disorders in the general population and within community or non-psychiatric clinical settings such as primary care or general medical out-patients. Four subscales—somatic symptoms, anxiety and sleeplessness, social dysfunction, and severe depression—make up the shorter, 28-item GHQ that was developed by Goldberg & Hillier[1].

Suitable for all ages from adolescent upwards (but not children), it assesses the respondent’s current state and asks if that differs from his or her usual state. It is an outcome measure that's sensitive to short-term psychiatric disorders but not to long-standing attributes of the respondent[2].

Intended Population[edit | edit source]

The self-administered questionnaire focuses on two major areas:

  • The inability to carry out normal functions
  • The appearance of new and distressing phenomena.


Method of Use[edit | edit source]

The self-administered questionnaire is an ideal screening device for identifying non-psychotic and minor psychiatric disorders to help inform further intervention.

GHQ-28: a 28 item scaled version – assesses somatic symptoms, anxiety, and insomnia, social dysfunction and severe depression.

GHQ28 4/5* (max score 28)

GHQ.jpg

Evidence[edit | edit source]

Montazeri et al., reported a Cronbach's alpha coefficient of 0.87 showing a satisfactory outcome from the reliability analysis. Inter-rater and intra-rater reliability have both been showed to be outstanding (Cronbach's 0.9-0.95) and test-retest reliability has been reported to be high (0.78 to 0 0.9)[3].

The GHQ-12 and global quality of life ratings significantly correlated negatively, as predicted, according to convergent validity (r = -0.56, P 0.0001)[4]. Also stated is high internal consistency[5]. The Hospital Depression and Anxiety Scale (HADS) and other measures of depression[3]are well correlated with the GHQ-28[6].

The responsiveness of the GHQ-28 in terms of minimal detectable change (MDC) and minimally clinically important difference (MCID) has not been determined because it was designed as a screening tool[2].


References[edit | edit source]

  1. Goldberg D., Hillier V. A scaled version of the General Health Questionnaire. Psychological Medicine. 1979; 9(1):139-145. doi:10.1017/S0033291700021644
  2. 2.0 2.1 Sterling M. General Health Questionnaire – 28 (GHQ-28). Journal of Physiotherapy. 2011; 57(4): 259. https://doi.org/10.1016/S1836-9553(11)70060-1
  3. 3.0 3.1 Robinson R.G., Price T.R. Post-stroke depressive disorders: A follow-up study of 103 patients. Stroke. 1982; 13(5):635-641
  4. Montazeri A., Harirchi A.M., Shariati M., Garmaroudi G., Ebadi M, Fateh A. The 12-item General Health Questionnaire (GHQ-12): Translation and validation study of the Iranian version. Health and Quality of Life Outcomes. 2003; 1:66. https://doi.org/10.1186/1477-7525-1-66
  5. Failde I., Ramos I., Fernandez-Palacín F. Comparison between the GHQ-28 and SF-36 (MH 1-5) for the assessment of the mental health in patients with ischaemic heart disease. European Journal of Epidemiology. 2000; 16(4):311-316
  6. Sakakibara B.M., Miller W.C., Orenczuk S.G., Wolfe D.L. A systematic review of depression and anxiety measures used with individuals with spinal cord injury. Spinal Cord. 2009; 47(12):841-851. https://doi.org/10.1038/sc.2009.93