Abstract
BackgroundThe 12-item General Health Questionnaire (GHQ-12) is widely used as a unidimensional instrument, but factor analyses tended to suggest that it contains two or three factors. Not much is known about the usefulness of the GHQ-12 factors, if they exist, in revealing between-patient differences in clinical states and health-related quality of life.MethodsWe addressed this issue in a cross-sectional survey of out-patients with psychological disorders in Singapore. The participants (n = 120) completed the GHQ-12, the Beck Anxiety Inventory, and the Short-Form 36 Health Survey. Confirmatory factor analysis was used to compare six previously proposed factor structures for the GHQ-12. Factor scores of the best-fitting model, as well as the overall GHQ-12 score, were assessed in relation to clinical and health-related quality of life variables.ResultsThe 3-factor model proposed by Graetz fitted the data better than a unidimensional model, two 2-factor models, and two other 3-factor models. However, the three factors were strongly correlated. Their values varied in a similar fashion in relation to clinical and health-related quality of life variables.ConclusionsThe 12-item General Health Questionnaire contains three factors, namely Anxiety and Depression, Social Dysfunction, and Loss of Confidence. Nevertheless, using them separately does not offer many practical advantages in differentiating clinical groups or identifying association with clinical or health-related quality of life variables.
Highlights
The 12-item General Health Questionnaire (GHQ-12) is widely used as a unidimensional instrument, but factor analyses tended to suggest that it contains two or three factors
Corti [3] analyzed the GHQ-12 data in the British Household Panel Survey (BHPS) and maintained that the high Cronbach's alpha value indicated the unidimensionality of this instrument
Diagnoses of recruited patients were ascertained by a psychiatrist using DSM-IV criteria and the severity of their psychiatric disorders was assessed using a Clinical Global Impression (CGI) scale, which ranges from 1 to 5
Summary
The 12-item General Health Questionnaire (GHQ-12) is widely used as a unidimensional instrument, but factor analyses tended to suggest that it contains two or three factors. Not much is known about the usefulness of the GHQ-12 factors, if they exist, in revealing between-patient differences in clinical states and health-related quality of life. The 12-item General Health Questionnaire (GHQ-12) has been widely used in many countries for detecting psychological morbidity. Some major national studies such as the British Household Panel Survey (BHPS) employ this instrument [2]. Calibration of this instrument may contribute significantly to a large community of researchers. Several authors suggested that the GHQ-12 contained two or three clinically meaningful factors. In a multi-centre study, considerable between-centre variation was found, the final solution tended to have either two or three factors [9]
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