[General Health Questionnaire-12 for the detection of depression]

Abstract

Objective: The aim of this study was to assess the validity and the possible cut-off points of the General Health Questionnaire-12 (GHQ-12) in detecting depression in university students.

Methods: The study included 170 students (115 females and 55 males) that consecutively applied to a university student health center psychiatric clinic and who were asked to complete a sociodemographic data form and the GHQ-12 before their visit with the psychiatrist. DSM-IV psychiatric diagnoses were established using the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).

Results: Depression was the most prevalent DSM-IV diagnosis (49%) and 35% of the students did not have any psychiatric diagnosis. Mean GHQ-12 score was 7.5+/-3.7 (8.0+/-3.6 for females and 6.4+/-3.7 for males, p<0.05). Sensitivity and specificity for depressive disorder were 83% and 65% (for the cut-off point 7/8), 75% and 77% (for the cut-off point 8/9), and 62% and 88% (for the cut-off point 9/10), respectively. The internal consistency (Cronbach's alpha 0.88) was good. Kappa coefficient for agreement between DSM diagnosis for depression and GHQ (cut-off 8/9) was 0.52. Item 9, which inquired about pleasure, produced the highest odds ratio for the diagnosis of depression (OR(CI)=11.84 (4.66-30.08)).

Conclusion: The results of this study revealed that GHQ-12 is a useful screening instrument for the detection of depression with a high cut-off point (8/9). The students' tendency to report more psychological symptoms and the administration of the instrument in a student psychiatric clinic could be the reasons for the high GHQ-12 cut-off points. We propose the use of high cut-off points for students who applied to a psychiatric clinic for more accurate detection of depression.