Validation of the Sinhala version of the 12-item General Health Questionnaire

Abstract

Objective To determine the criterion validity of the Sinhala version of the General Health Questionnaire-12 (GHQ-12). Methods This was a descriptive cross-sectional study including 374 patients (between the ages 18 to 75 years) attending the outpatient department of the Colombo North Teaching Hospital during the period June 2009 to September 2010. The Sinhala version of the GHQ-12 was completed by the participants. The 'Clinical Examination' was done by the designated psychiatrist (blindly to the GHQ score) by employing the ICD 10 classification of 'Depression/Anxiety and Social Dysfunction' as a reference standard. Cut-off values for the GHQ-12 were determined by applying the Receiver Operation Characteristic (ROC) curves. Results The optimal cut-off level for GHQ-12 was 1/2 with a sensitivity of 74% (95%CI 66%-81.5%), and a specificity of 71% (95%CI: 65.4%–76.6%). Optimal cut-off levels were not changed based on gender, age and educational levels. The area under the ROC curve for GHQ-12 was 0.79 (95% CI: 74%–84%). Despite the above mentioned statistics/measurements, GHQ scores with specific likelihood ratios of >1 were obtained only for the total scores of ≥3. Conclusions The GHQ-12 displays its efficacy when used among the Sinhala speaking Sri Lankan primary care settings for assessing psychiatric disorders.