title: Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population.
abstract: OBJECTIVE
  The 12-item version of the General Health Questionnaire (GHQ-12) is frequently used to measure common mental disorder in public health surveys, but few population-based validations have been made. We validated the GHQ-12 against structured psychiatric interviews of depression using a population-based cohort in Stockholm, Sweden.
  
  
  METHODS
  We used a population-based cohort of 484 individuals in Stockholm, Sweden (participation rate 62%). All completed the GHQ-12 and a semi-structured psychiatric interview. Last month DSM-III-R symptoms were used to classify major and minor depression. Three scoring methods for GHQ-12 were assessed, the Standard, Likert and Corrected method. Discriminatory ability was assessed with area under the receiver operating characteristic (ROC) curve.
  
  
  RESULTS
  A total of 9.5% had a major or minor depression. The area under the ROC curve was for the Standard method 0.73 (0.65-0.82), the Likert method 0.80 (0.72-0.87) and the Corrected method 0.80 (0.73-0.87) when using major or minor depression as standard criterion. Adequate sensitivity and specificity for separating those with or without a depressive disorder was reached at ≥12 Likert scored points (80.4 and 69.6%) or ≥6 Corrected GHQ points (78.3 and 73.7%). Sensitivity and specificity was at ≥2 Standard scored points 67.4% and 74.2%.
  
  
  CONCLUSIONS
  When scored using the Likert and Corrected methods, the GHQ-12 performed excellently. When scored using the Standard method, performance was acceptable in detecting depressive disorder in the general population. The GHQ-12 appears to be a good proxy for depressive disorder when used in public health surveys.
authors.affiliation: Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Electronic address: andreas.lundin@ki.se.
authors.forename: A
authors.initials: A
authors.lastname: Lundin
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Hallgren
authors.affiliation: Academic Primary Health Care Centre, Stockholm County Council and Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Theobald
authors.affiliation: Swedish Council for Higher Education, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Hellgren
authors.affiliation: Department of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Torgén
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013548:Sweden
keywords: Anxiety; Area under the curve; Depression; GHQ-12; Self-assessment; Sensitivity and specificity