THE VALIDATION OF THE GENERAL HEALTH QUESTIONNAIRE (GHQ-28) IN A PRIMARY CARE SETTING IN SAUDI ARABIA

OBJECTIVE: The objective of this study was to validate an Arabic version of the General Health Questionnaire (GHQ-28) in a primary care setting in Saudi Arabia. METHODOLOGY: A total of 60 Saudi patients selected by means of systematic random sampling were asked to fill out the GHQ-28 Arabic version. The psychiatrist interviewed all patients using the Arabic version of the Clinical Interview Schedule (CIS). RESULTS: The best cut-off level for the GHQ-28 indicating best trade-off between sensitivity and specificity was 4/5, where the validity values were, sensitivity; 72%, specificity; 74%, positive predictive value; 72%, negative predictive value; 74% and misclassification rate; 27%. The correlation coefficient was r = +0.61 and the Spearman's Rank-difference correlation was rs = +0.57. The area under the ROC Curve was 69%. The cut-off point 4/5 in this study is the same as recommended by others in primary care settings. Although the validity parameters are relatively low, they are within the range found by other studies in USA, UK and developing countries. This supports the suggestion to develop an Arabic Screening Questionnaire based on the translated GHQ with the addition of culturally specific items. CONCLUSION: The GHQ-28 Arabic Version is a valid instrument that may be of great help to primary care doctors in improving detection of psychiatric morbidity and in epidemiological research.