The psychometric properties of GHQ for detecting common mental disorder among community dwelling men in Goa, India

Highlights

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  GHQ-12 is fairly effective, efficient screening tool for CMD in Goa, India.

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  Optimal cut-off score was found to be lower than WHO-recommended score.

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  Lowered cut-off point is recommended in Goa, India for community use.

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  Cut-off point may have implications for CMD identification in community.

Abstract

Background

There have not been many attempts to validate screening measures for common mental disorders (CMD) in low- and middle-income countries. The aim of this study was to examine the criterion validity of the General Health Questionnaire 12 (GHQ-12) in a community-based study from Goa, India.

Method

Concurrent and convergent validity of the GHQ-12 were assessed against the Mini International Neuropsychiatric Interview (MINI) and World Health Organization Disability Assessment Scale (WHODAS) for CMD and functional status through the secondary analysis of a community cohort of men from Goa, India. Criterion validity of the GHQ-12 was determined using ROC analyses with the MINI case criterion as the gold standard. Concurrent validity was assessed against the gold standard of WHODAS functional disability and number of disability days.

Results

In a sample of men ( n = 773), the GHQ-12 showed high internal reliability (Cronbach's alpha of 0.82) and acceptable criterion validity (Area under the receiver operating characteristic curve being 0.71). It had adequate psychometric properties for the detection of CMD (sensitivity of 68.75%; specificity of 73.14%) with the optimal cut-off score for identification of CMD being 2.

Conclusion

In order to optimize the usefulness and validity of the GHQ-12, a low cut-off point for CMD may be beneficial in Goa, India. Further validation studies for the GHQ-12 should be conducted for continued validation of the test for use in the community.