The GHQ-12 as a screening tool in a primary care setting

Area of Science:

• Psychiatry
• Epidemiology
• Primary Care Medicine

Background:

• The General Health Questionnaire (GHQ) is a widely used screening tool for detecting psychological distress.
• Accurate mental health screening in primary care is crucial for timely intervention.
• Validation of screening tools against structured diagnostic interviews is essential for clinical utility.

Purpose of the Study:

• To evaluate the performance of the 12-item General Health Questionnaire (GHQ-12) in a primary care setting.
• To compare the GHQ-12's diagnostic accuracy against the Composite International Diagnostic Interview (CIDI) for DSM III-R disorders.
• To assess the feasibility and reliability of both instruments in Yoruba.

Main Methods:

• A population of 787 primary care patients was studied, with 214 undergoing interviews.
• The Yoruba versions of the GHQ-12 and a modified CIDI were administered.
• Sensitivity and specificity of the GHQ-12 were calculated against CIDI-based diagnoses.

Main Results:

• The GHQ-12 achieved a sensitivity of 68% and a specificity of 70% for specific DSM III-R disorders.
• Inter-rater reliability of the CIDI was found to be good.
• The Yoruba versions of both instruments were feasible in the primary care setting.
• Revised scoring methods marginally improved the GHQ-12's overall performance.

Conclusions:

• The GHQ-12 is a feasible and moderately accurate screening tool for mental health disorders in primary care among Yoruba speakers.
• The CIDI demonstrated good reliability for diagnosing DSM III-R disorders in this population.
• Further refinement of scoring methods may enhance the GHQ-12's diagnostic utility.