Why GHQ threshold varies from one place to another

Abstract

The GHQ threshold is partly determined by the prevalence of multiple diagnoses, with higher thresholds being associated by higher rates of both single and multiple diagnosis. The mean GHQ score for the whole population of respondents provides a rough guide to the best threshold. In those centres where the discriminatory power of the GHQ is lowest, it is necessary to use a low threshold as a way of ensuring that sensitivity is protected, but the positive predictive value of the GHQ is then lower. Some of the variation between centres is due to variation in the discriminatory power of different items.

Identification with social groups is associated with mental health in adolescents: Evidence from a Scottish community sample

“…Each participant's 12 binary scores were then summed to create a GHQ-12 score, which could range between 0 and 12, with higher values indicating poorer mental health (Cronbach's α = 0.89). Goldberg et al (1998) suggested that the optimal cut-off threshold for the GHQ-12 should be between 3 and 4 (with a score of 3 indicating the absence of a mental disorder, and a score of 4 indicating the presence of a mental disorder). Moreover, Hardy et al (1999) claimed that this threshold gives the best conservative estimate of minor psychiatric morbidity.…”

Psychological health of Australian veterans of the 1991 Gulf War: an assessment using the SF-12, GHQ-12 and PCL-S

“…In regard to choice of caseness threshold or cut-off score, previous Gulf War studies (Unwin et al 1999) using the GHQ-12 have solely involved UK veterans and employed a fixed cut-off of three or more symptoms. There is strong evidence, however, that optimal GHQ cut-off scores vary geographically (Goldberg et al 1997(Goldberg et al , 1998. Donath (2001) found the optimal cut-off for the general Australian population to be one or more symptoms.…”

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

“…In our study, the reference standard was an assessment made by a psychiatrist using consistent standard criteria. The various methods give different results because of diversity in defining 'caseness' 10 . Goldberg 4 reported that the 'Clinical Interview Schedule' is almost identical to that which is used for the 'Present State Examination' in determining the validity.…”