The performance of the K10, K6 and GHQ-12 to screen for present state DSM-IV disorders among disability claimants

Abstract

BackgroundScreening for mental disorders among disability claimants is important, since mental disorders seem to be seriously under-recognized in this population. However, performance of potentially suitable scales is unknown. We aimed to evaluate the psychometric properties of three scales, the 10- and 6-item Kessler Psychological Distress Scale (K10, K6) and the 12-item General Health Questionnaire (GHQ-12), to predict present state mental disorders, classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4thEdition (DSM-IV) among disability claimants.MethodsAll scales were completed by a representative sample of persons claiming disability benefit after two years sickness absence (n=293). All diagnoses, both somatic and mental, were included. The gold standard was the Composite International Diagnostic Interview (CIDI 3.0) to diagnose present state DSM-IV disorder. Cronbach’s α, sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and the areas under the Receiver Operating Characteristic curve (AUC) were calculated.ResultsCronbach’s alpha’s were 0.919 (K10), 0.882 (K6) and 0.906 (GHQ-12). The optimal cut-off scores were 24 (K10), 14 ( K6) and 20 (GHQ-12). The PPV and the NPV for the optimal cut point of the K10 was 0.53 and 0.89, for the K6 0.51 and 0.87, and for the GHQ-12 0.50 and 0.82. The AUC’s for 30-day cases were 0.806 (K10; 95% CI 0.749-0.862), 0.796 (K6; 95% CI 0.737-0.854) and 0.695 (GHQ-12; 95% CI 0.626-0.765).ConclusionsThe K10 and K6 are reliable and valid scales to screen for present state DSM-IV mental disorder. The optimal cut-off scores are 24 (K10) and 14 (K6). The GHQ-12 (optimal cut-off score: 20) is outperformed by the K10 and K6, which are to be preferred above the GHQ-12. The scores on separate items of the K10 and K6 can be used in disability assessment settings as an agenda for an in-depth follow-up clinical interview to ascertain the presence of present state mental disorder.

Psychological Distress and Hypertension: Results from the National Health Interview Survey for 2004-2013

“…Based on the K6 scaling system, a score ≥13 indicated psychological distress, and this was referenced to those who reported a cumulative mood index <13 [14]. Internal consistency for the K6 scores has been reported by estimates of Cronbach's α at 0.89 and 0.93 [9,10]. Other independent variables included sociodemographic variables associated with psychological or social stress like age, sex, race, high school completion, poverty status, marital status, earnings and poverty level.…”

“…The K6 is a well-validated measure of psychological symptoms [9,10]. It could also be used as a mental health screening instrument in the primary care health setting [11,12].…”

Is Test Anxiety a Problem Among Medical Students: A Cross Sectional Study on Outcome of Test Anxiety among Medical Students?

“…The total score of 10 to 20 indicated non-distress while score of 21 to 50 was considered as distress. This scale has adequate reliability and the cronbach's alpha's were 0.919 (Cornelius, Groothoff, van der Klink, & Brouwer, 2013). Though it is moderately reliable instrument, this scale has been widely used by many researchers to measure psychological researchers.…”

Three Years After Black Saturday

“…31 It is a widely used screening tool for mental health issues in community samples. 32 Recently, a Cronbach's α of 0.91 has been determined by Cornelius et al 33 The K-10 asks about the level of anxiety and depressive symptoms experienced in the most recent 4-week period. Responses range from 1 ("none of the time") to 5 ("all of the time") and are summed with higher scores indicating greater distress.…”