Psychiatric diagnosis in family practice: is the general health questionnaire an effective screening instrument?

The General Health Questionnaire has been considered an effective screening instrument in a family practice population. To evaluate its efficiency in identifying psychologic distress, 1,000 consecutive attenders at the Family Practice Clinic were given the 30 item GHQ. Of the patients from the sample, 35% were identified by the GHQ as having psychologic distress. In contradistinction, 14.8% of the group were given clinical psychiatric diagnoses by the physician. The presence of a positive GHQ score did not correlate with frequency of follow-up visits or other behavioral parameters. The presence of a psychiatric diagnosis, however, was significantly associated with frequency of follow-up visits. These findings do not invalidate the General Health Questionnaire but may reflect low case identification. The health behavior of patients with psychologic distress may be, in part, a function of the labeling process as well as the emotional illness itself.