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The Validation of the GHQ-28 and the use of the MMSE in Neurological In-Patients

Published online by Cambridge University Press:  29 January 2018

K. W. Bridges*
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL (formerly Clinical Research Fellow, University of Manchester)
D. P. Goldberg
Affiliation:
Department of Psychiatry, University Hospital of South Manchester, West Didsbury, Manchester M20 8LR
*
Correspondence

Abstract

The routine use of screening instruments for psychiatric and cognitive impairment in hospital in-patients has been recommended in the United States. The validity of the scaled version of the General Health Questionnaire (GHQ-28) and the clinical utility of the Mini-Mental State Examination (MMSE) were therefore evaluated in a consecutive series of neurological in-patients (N=102). Using Receiver Operating Characteristic (ROC) analysis, the discriminating power of the GHQ was very good, and best when using a threshold score of 11/12. The patient sample turned out not to contain any with generalised cortical damage, which casts some doubt on whether the MMSE should be used routinely in all neurological in-patients units in the UK.

Type
Papers
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

Anthony, J. C., Leresdre, L., Niaz, U., Von Korff, M. R. & Folstein, M. G. (1982) Limits of the Mini-Mental State as a screening test for dementia and delirium among hospital patients. Psychological Medicine, 12, 397409.Google Scholar
Banks, M. H. (1983) Validation of the GHQ in a young community sample. Psychological Medicine, 13, 349355.Google Scholar
Berwick, D. M. & Thibodeau, L. A. (1983) Receiver operating characteristic analysis of diagnostic skills. Medical Care, 21, 876885.CrossRefGoogle Scholar
Bridges, K. W. (1983) A study of psychiatric morbidity in patients admitted to an adult neurology ward. University of Manchester M.Sc. thesis.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1984) Psychiatric illness in inpatients with neurological disorders: patients' views on discussion of emotional problems with neurologists. British Medical Journal, 289, 656658.Google Scholar
Cavanaugh, S. (1983) The prevalence of emotional and cognitive dysfunction in a general medical population: using the MMSE, GHQ and BDI. General Hospital Psychiatry, 5, 1524.Google Scholar
Cooper, B. (1979) Demographic and Epidemiological Methods in Psychiatric Research. In Psychiatrie der Gegenwart, Bd. 1/1, 2 And. (eds. Kiskar, K. P., Muller, J. E. & Stromgren, E.). Berlin: Springer-Verlag.Google Scholar
DePaulo, J. R. & Folstein, M. F. (1978) Psychiatric disturbance in neurological patients: Detection, recognition and hospital course. Annals of Neurology, 4, 225228.Google Scholar
DePaulo, J. R. & Folstein, M. F. & Gordon, B. (1980) Psychiatric screening on a neurological ward. Psychological Medicine, 10, 125132.Google Scholar
Dick, J. P. R., Guiloff, R. J., Stewart, A., Blackstock, J., Bielawska, C., Paul, E. A. & Marsden, C. D. (1984) Mini-Mental State examination in neurological patients. Journal of Neurology, Neurosurgery & Psychiatry, 47, 496499.Google Scholar
Erdreich, L. S. & Lee, E. T. (1981) Use of relative operating characteristic analysis in epidemiology. American Journal of Epidemiology, 114, 649662.Google Scholar
Finlay-Jones, R. A. & Murphy, E. (1979) Severity of psychiatric disorder and the 30-item GHQ. British Journal of Psychiatry, 134, 609616.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Goldberg, D. P. (1972) The detection of psychiatric illness by questionnaire. Maudsley Monograph No. 21, Oxford University Press.Google Scholar
Goldberg, D. P. (1978) Manual of the General Health Questionnaire. Slough: National Foundation for Educational Research.Google Scholar
Goldberg, D. P. & Hillier, V. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139145.CrossRefGoogle ScholarPubMed
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970) A standardised psychiatric interview for use in community surveys. British Journal of Preventive & Social Medicine. 24, 1823.Google ScholarPubMed
Hanley, J. A. & McNeil, B. J. (1982) The meaning and use of the area under a Receiver Operating Characteristic (ROC) curve. Radiology, 143, 2936.Google Scholar
Kirk, C. A. & Sauders, M. (1979) Psychiatric illness in a neyrological out-patient department in North East England. Acta Psychlatrica Scandinavica, 60, 427437.Google Scholar
Knights, E. B. & Folstein, M. F. (1977) Unsuspected emotional and cognitive disturbance in medical patienu. Annals of Internal Medicine, 87, 723724.Google Scholar
Maguire, G. P., Julier, D. L., Hawton, K. E. & Bancroft, J. H. J. (1974) Psychiatric morbidity and referral on two general medical wards. British Medical Journal, i, 268270.CrossRefGoogle Scholar
Mari, J. Williams, P. (1985) A comparison of the validity of two psychiatric questionnaires (GHQ-12 and SRQ-20) in Brazil, Using Relative Operation Characteristic (ROC) Analysis. Psychological Medicine, 15, 651659.CrossRefGoogle ScholarPubMed
McNeil, B. J. & Adelstein, S. J. (1976) Determining the value of diagnostic and screening tests. Journal of Nuclear Medicine. 17, 439448.Google ScholarPubMed
McNeil, B. J., Keeler, E. & Adelstein, S. J. (1975) Primer on certain elements of medical decision making. The New England Journal of Medicine. 293, 211215.Google Scholar
Metz, C. E. (1978) Basic principles of ROC analysis. Seminars in Nuclear Medicine. 8, 283298.CrossRefGoogle ScholarPubMed
Office Of Population Censuses and Surveys (1971) Greater Britain: Economic Activity. London: HMSO.Google Scholar
Office Of Population Censuses and Surveys (1981) County reports: Greater Manchester. London: HMSO.Google Scholar
Rabins, P. V. & Brooks, B. R. (1981) Emotional disturbance in multiple sclerosis patients: validity of the General Health Questionnaire. Psychological Medicine, 11, 425427.Google Scholar
Simpson, N. J. (1984) The use of a self-administered questionnaire to detect psychiatric illnesses using the criteria of DSM. III—a pilot study. University of Manchester M.Sc. thesis.Google Scholar
Swets, J. A. (1973) The Relative Operating Characteristic in Psychology. Science. 182, 9901000.Google Scholar
Swets, J. A., Pickett, R. M., Whttehead, S. F., Getty, D. J., Schmur, J. A., Swets, J. B. & Freeman, B. A. (1979) Assessment of diagnostic technologies. Science. 205, 753759.CrossRefGoogle ScholarPubMed
Wing, J. K., Birley, J. L. T., Cooper, J. E., Graham, P. & Issaacs, A. (1967) Reliability of a procedure for measuring and classifying ‘Present Psychiatric State’. British Journal of Psychiatry. 113, 499515.Google Scholar
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