A scaled version of the General Health Questionnaire

Area of Science:

• Psychiatry and Mental Health
• Primary Care Medicine
• Psychometrics

Background:

• The General Health Questionnaire (GHQ) is widely used for mental health screening.
• Its application in primary care settings requires validation of its factor structure and psychometric properties.
• Existing GHQ versions may be lengthy for routine primary care use.

Purpose of the Study:

• To determine the factor structure of General Health Questionnaire symptoms in a primary care population.
• To propose and evaluate a shorter, 28-item version of the GHQ with distinct subscales.
• To assess the validity and screening performance of the proposed 28-item GHQ.

Main Methods:

• Factor analysis was applied to symptom data from the General Health Questionnaire in a primary care setting.
• A 28-item version was developed, comprising four proposed subscales: somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression.
• Data from three independent sets were used to confirm the factor structure and evaluate the questionnaire's performance.

Main Results:

• The factor structure of the GHQ symptomatology was found to be highly consistent across three independent datasets.
• A robust 4-factor structure emerged, supporting the proposed subscales: somatic symptoms, anxiety/insomnia, social dysfunction, and severe depression.
• Preliminary validity data and screening performance evaluations indicate the 28-item GHQ is a promising tool for primary care.

Conclusions:

• The 28-item General Health Questionnaire demonstrates a consistent and valid factor structure for primary care settings.
• This shorter version, with its defined subscales, offers an efficient tool for screening mental health symptoms.
• The proposed GHQ revision is suitable for use as a screening test in primary care environments.