Measurement of psychological distressDuring a household visit, interviewers collected information using computer assisted personal interviewing modules. We measured psychological distress using the 12 item version of the General Health Questionnaire (GHQ 12), a widely used measure of https://www.demetz.co.uk distress in population studies.17 18 The GHQ 12 is generally considered to be a unidimensional scale of psychological distress,19 consisting of items capturing symptoms of anxiety, depression, social dysfunction, and loss of confidence. Study members respond to whether a symptom is present by using a four point Likert scale (“not at all”=0, “same as usual”=0, “more than usual”=1, “much more than usual”=1). A total GHQ 12 score of four or greater leads to people being defined as psychological distress “cases” and scores 0 3 as “non cases”; this definition has been validated against standardised psychiatric interviews and has been adidas yeezy uk black
strongly associated with various psychological disorders such as depression and anxiety.20 21 Most previous studies used such a dichotomy and few have examined associations across the full range https://www.demetz.co.uk of psychological distress. No standard cut off values exist for dividing up “cases” identified by a GHQ 12 score threshold. We therefore chose to divide people into four groups based on their GHQ 12 score: asymptomatic (score 0), subclinically symptomatic (score 1 3), symptomatic (score 4 6), and highly symptomatic (score 7 12).
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