The psychiatric correlates of coronary pathology: validity of the GHQ-60 as a screening instrument.

The 60-item General Health Questionnaire (GHQ) and the Clinical Interview Schedule (CIS) were administered to a consecutive series of 194 patients with established or presumptive coronary heart disease (CHD) attending an out-patient cardiology unit. The GHQ proved to be a valid instrument for the routine screening of this population. The presence of organic anginal pain was associated with high scores on the GHQ, but with a lower specificity and a higher percentage of false positives. This was not found in patients with atypical or non-cardiac chest pain. These findings suggest a need for an upward revision of the cut-off score on the GHQ in patients with organic anginal pain. False negatives were found predominantly among patients with personality disorders, and in those characterized by the longstanding nature of their symptomatology and by higher levels of defensiveness.