The aim was to examine the psychometric properties of the Arabic 12-item General Health Questionnaire in a sample of university students. A sample of 157 university students was screened using this questionnaire and the Hopkins Symptom Checklist-90. A standardized clinical interview using SCID was conducted on a subset of screened students. Reliability, validity, and factor analysis of the questionnaire were evaluated. Using factor score discrimination between cases and noncases was also evaluated. The Arabic version of the GHQ-12 proved to be reliable as indicated by Cronbach alpha of .86. The best balance between sensitivity and specificity was found at the General Health Questionnaire cut-off point of 15/16: at this threshold, sensitivity was .88 and was paired with a specificity of .84. Principal component analysis with varimax rotation identified three factors, namely, Factor A (general dysphoria), Factor B (lack of enjoyment), and Factor C (social dysfunction). Factors A and C discriminated between clinically distressed and clinically nondistressed subjects. The General Health Questionnaire-12 as a whole is a reliable and valid screening tool in university settings.
The Arabic version of the Hospital Anxiety and Depression (HAD) scale was retested and cut-off points determined in a sample of 217 patients attending a primary health care centre in Al Ain, United Arab Emirates (U.A.E.). Subjects were screened using the HAD scale and all patients were then interviewed by a single consultant psychiatrist. The scale scores were assessed against the psychiatrist's clinical evaluations. The study furnished evidence that the Arabic version of the HAD scale is a valid instrument for detecting anxiety and depressive disorders in primary health care settings. Spearman rank correlations of all items of the scale were significantly above zero. The butterflies item of the anxiety subscale had the lowest correlation coefficients. The overall Cronbach alpha measures of internal consistency were 0.7836 and 0.8760 for anxiety and depression, respectively. The cut-off points that produced a balanced combination of sensitivity and specificity appropriate for referral to a psychiatric facility by the general practitioner were 6/7 for anxiety and 3/4 for depression. Almost all other similar studies have determined a single cut-off point for both subscales of the HAD. This study also indicated that the HAD depression subscale is more consistent and more predictive than the HAD anxiety subscale. Moreover some of the problems arising from applying psychiatric research instruments across cultures are highlighted by this study.
The Arabic version of the HAD scale was validated in a sample of 50 Saudi patients. The scale scores were assessed against the principal author's clinical evaluations. Spearman correlations of all items of the scale, except for one, were statistically significant. The non-significance of one item was probably related to the way it was translated into Arabic. The study furnished evidence that the Arabic version was a reliable instrument for detecting states of anxiety and depression in Saudi patients in a primary health care setting.
The Arabic versions of both GHQ-30 and GHQ-12 are valid psychiatric screening instruments, with almost similar performance, for Arabic-speaking PHC patients.
The strong influence of psychiatric disorders e.g., depression, anxiety, organic brain syndrome, and hypochondriasis rather than physical disorders suggests that a lack of meaning and worries are more detrimental to life satisfaction than physical frailty. The findings underscore the need to develop interventions that help older people deal more effectively with psychiatric disorders and its comorbidities. Moreover, the results suggest that providing family support, by not allowing older adults to live alone, may be especially helpful for older adults.
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