Validity of the Use of GHQ-12 in Primary Health Care Setting in Northern Nigeria

Abstract

Background: Primary health care is the first point of entry into medical care and is often heavily attended. The attending health personnel require tools that can quickly assess the health needs of the patients both physically and mentally. A screening instrument such as the General Health Questionnaire (GHQ-12) will be useful in Primary Health Care setting for detecting emotional distress/probable psychological disorder if the diagnoses were largely in agreement with standardized diagnostic tool. The objective of the study was to determine the validity of the use of GHQ-12 and its agreement with standardized diagnostic tool (Schedule for Clinical Diagnosis for DSM-IV: SCID) in identifying emotional distress/probable psychological disorders. Method: It was a cross-sectional study involving one hundred and fifty patients attending Primary Health Care Centre selected randomly and interviewed in two stages. At the first stage, all the subjects completed socio-demographic and GHQ-12 questionnaires administered by the PHC staff. At the second stage, all subjects diagnosed as having emotional distress by GHQ-12 and few of those that screened negative were interviewed with anxiety and depressive modules of Structured Clinical Interview for DSM-IV Disorders (SCID) by the author. Result: The GHQ-12 identified 41 (27.3 %) of the subject as meeting criteria for emotional distress/probable psychological disorder at a threshold score of 3 and above. The SCID identified 38 subjects to be having emotional disorders (25.3%). Thirty-four of the subjects identified with emotional disorders with SCID has a positive GHQ-12 Score of 3 and above; giving sensitivity rate of 89.5%% agreement rate of 82.9%
Conclusion: The GHQ-12 has a good validity property with high diagnostic concordance with standard diagnostic tool. The GHQ-12 is easy and can be administered by health personnel at primary health care level to identify those in need of mental health services who may require referral to higher treatment level.