• Self-report questionnaire
  • Used for the detection of psychiatric distress related to general medical illness. Respondents indicate if their current “state” differs from his or her usual state – thereby assessing change in characteristics and not lifelong personality characteristics.
  • Designed to assess 4 aspects of distress:
    1. Depression
    2. Anxiety
    3. Social impairment
    4. Hypochondriasis

Clinical Considerations

  • The GHQ-28’s subscales represent dimensions of symptomatology and not distinct diagnoses.
  • As the scales are not independent of each other, the total score has better utility to indicate general psychological disorder than the individual scores do to screen for specific psychological disorders.
  • Only one study has assessed the construct validity of the GHQ-28 among SCI populations.
  • The GHQ-28 is appropriate for individuals who are at least 11 years of age.

ICF Domain

Body Function ▶ Mental Functions

Administration

  • Self-administered questionnaire
  • Patients base their responses on their health state over the past two weeks.
  • Administration time is usually approximately 5 minutes.

Number of Items

28

Equipment

None

Scoring

  • Calculation of total score
  • Different scoring methods of scoring are possible, which will affect the total score. The traditional scoring method provided assigns a score of 0 for responses 1 and 2 (“not at all” and “no more than usual”) and a score of 1 for responses 3 and 4 (“rather more than usual” and “much more than usual”). Another scoring method in use assigns a score of 0 for response 1 and a score of 1 for response 2-4 for the 18 negative items, and a score of 0 for responses 1 and 2, a score of 1 for responses 3 and 4 for the 7 positive items.

Languages

Translated into 38 languages

Training Required

None

Availability

Currently unavailable.

# of studies reporting psychometric properties: 1

Interpretability

MCID: not established
SEM: not established
MDC: not established

  • Total score range from 0 to 28.
  • Higher scores indicate a greater probability of a psychiatric distress.
  • Total scores that exceed 4 out of 28 suggest probable distress.
  • Cut-points and normative data have not been established for the population with SCI.

Reliability

No values have been reported for the reliability of the GHQ-28 for the population with SCI.

Validity

  • Correlation of the GHQ-28 is High with the Clinical Interview Scale (r = 0.83).
  • With the 0011 scoring scheme, optimum discrimination occurred near GHQ 3/4, giving a specificity of 0.82 and a sensitivity of 0.81.

(Griffiths et al. 1993: n=60, 77% males; median duration of paralysis: 7 years)

Responsiveness

No values have been reported for the responsiveness of the GHQ-28 for the population with SCI.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the GHQ-28 for the population with SCI.

Reviewer

Dr. Carlos L. Cano, Tyra Chu

Date Last Updated

12 February 2024

Chung MC, Preveza E, Papandreou K, Prevezas N. Spinal cord injury, posttraumatic stress, and locus of control among the elderly: a comparison with young and middle-aged patients. Psychiatry 2006; 69: 69-80.
http://www.ncbi.nlm.nih.gov/pubmed/16704333

Griffiths TC, Myers DH, Talbot AW. A study of the validity of the scaled version of the General Health Questionnaire in paralysed spinally injured out-patients. Psychol Med 1993; 23: 497–504.
http://www.ncbi.nlm.nih.gov/pubmed/8332663

Goldberg DP, Hillier VF. A Scaled Version of the General Health Questionnaire. Psychol Med 1979; 9: 139-145.
http://www.ncbi.nlm.nih.gov/pubmed/424481

Lykouras L, Adrachta D, Kalfakis N, Oulis P, Voulgari A, Christodoulou GN, Papageorgiou C, Stefanis C. GHQ-28 as an aid to detect mental disorders in neurological inpatients. Acta Psychiatr Scand, 1996; 93(3): 212-216.
http://www.ncbi.nlm.nih.gov/pubmed/8739669

Rush JA, First MB, Blacker D. Handbook of Psychiatric Measures. American Psychiatric Pub. 2008.
http://holyspiritlibrary.pbworks.com/f/Handbook+Psychiatric+Measures.pdf

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