Introduction to the GHQ-28: Assessing Mental Health
GHQ-28 (General Health Questionnaire-28) – 28-Item General Health Questionnaire
A standard tool for assessing mental health, psychological distress, and emotional–social problems across four core domains
Brief overview of the GHQ-28 Overview
The GHQ-28, or 28-item General Health Questionnaire, is one of the best-known instruments for screening mental health in the general population and in primary care settings. It is designed to identify people who may be struggling with psychological distress, emotional difficulties, or reduced day-to-day functioning.
The GHQ-28 consists of four 7-item subscales that cover key symptom areas: somatic complaints, anxiety and insomnia, social dysfunction, and severe depression. Completing the questionnaire usually takes around 5–10 minutes.
What is the GHQ-28? What is GHQ-28?
The General Health Questionnaire (GHQ) was developed by Goldberg and Hillier to assess mental health in primary care and in community samples. The GHQ-28 is one of the most widely used versions, containing 28 items and translated and standardized in many countries.
The questionnaire focuses on recent changes in emotional state and functioning: it asks how the person’s current situation differs from their “usual” state in the recent past. Its main aim is to identify individuals who may need further evaluation or professional support.
- Instrument type: self-report screening questionnaire for mental health
- Typical settings: primary care, public health programs, population surveys
- Response format: 4-point scale based on change compared to usual state
What does the GHQ-28 measure and who is it for? Domains & Target Group
The GHQ-28 has four main subscales, each containing 7 items that capture key aspects of everyday mental health:
- Somatic symptoms: feelings of fatigue, physical discomfort, and bodily complaints often related to stress.
- Anxiety & insomnia: tension, worry, restlessness, and sleep problems.
- Social dysfunction: difficulties in carrying out daily tasks, reduced productivity, and a sense of not coping well in social or role responsibilities.
- Severe depression: marked sadness, loss of interest, and negative thoughts about oneself and the future.
The questionnaire is intended for older adolescents and adults and can be used both in the general population and among clients of health and counseling services.
Applications of the GHQ-28 Applications
Because it is relatively brief and well validated, the GHQ-28 is used in a wide range of contexts:
- Initial screening for psychological difficulties in general medical and health-care settings
- Monitoring mental health in staff, students, or community samples in welfare and workplace programs
- Examining how stressful events (for example crises or physical illness) affect mental health
- Serving as a broad index of psychological distress in epidemiological and academic research
How is the GHQ-28 administered? Administration
The GHQ-28 consists of 28 questions, each addressing an aspect of feelings, thoughts, or everyday functioning. Respondents rate their current state compared to how they usually feel and function.
- Number of items: 28, grouped into 4 subscales
- Response format: 4-point scale indicating degree of change compared with usual state
- Administration: self-report; can be completed on paper or online
- Estimated time: around 5–10 minutes
Before you complete the GHQ-28 Before You Start
- Try to answer the items in a calm place with minimal distractions.
- It is best to complete the questionnaire in one sitting, without long breaks.
- Answer based on how you have felt in recent weeks compared to your usual state.
- The goal is to understand your mental health more clearly; answer honestly, without filtering or “presenting yourself better”.
- For each question, go with your first, most typical impression rather than overthinking your responses.
Interpreting GHQ-28 scores Interpretation
GHQ-28 results are usually reported as a total score plus four subscale scores. Higher scores indicate a higher likelihood of psychological distress. In many versions, a cut-off score is used to indicate whether a person is likely to be a “possible case” of mental-health difficulties and may benefit from a fuller assessment.
However, the GHQ-28 is not designed for final diagnosis of psychiatric disorders. Instead, it signals who may need more detailed clinical evaluation.
- Higher scores suggest a greater probability of significant distress.
- The pattern of scores across subscales can highlight whether difficulties are mainly in anxiety, social functioning, depression, or somatic complaints.
- Interpretation should always take into account life circumstances, stressors, and available social support.
- If scores are high or if there is concern, consultation with a mental-health professional is recommended.
Key domains measured by the GHQ-28 Health Map
You can think of the GHQ-28 as a map of mental health across four core domains, ranging from physical complaints to social functioning and deeper mood:
Frequently asked questions about the GHQ-28 FAQ
No. The GHQ-28 is a screening tool, not a full diagnostic instrument. It indicates the likelihood of psychological distress, but formal diagnosis of psychiatric disorders always requires a clinical interview and a comprehensive assessment by a qualified professional.
The GHQ-28 is typically used with older adolescents and adults. For younger age groups or specific populations (for example older adults with cognitive impairment), other tools or more cautious interpretation may be needed.
Depending on the purpose, the GHQ-28 can be repeated every few weeks or months to track changes in mental health. In screening programs or research studies, the interval between administrations should be planned according to the study design and the advice of qualified professionals.
The GHQ-28 has been examined in many international studies and generally shows good reliability and validity. However, accuracy also depends on the quality of the translation, cultural adaptation, local norms, and how the questionnaire is administered in each population.
Yes. The GHQ-28 is one of the most frequently used instruments in mental-health research. Many population, workplace, and clinical studies use it to measure general mental health and examine its relationship with other variables—provided that ethical principles and usage rights are respected.
Ethical considerations when using the GHQ-28 Ethical Considerations
- Responses should be kept confidential and used only for legitimate professional or research purposes.
- Results must not be used to stigmatize, label, or make moral judgments about individuals.
- Participants should know that completing the questionnaire is voluntary and that they may stop at any time if they feel uncomfortable.
- If scores are high or the person is worried about their mental health, suggesting a consultation with a psychologist or psychiatrist is important.
- When results are used in high-stakes decisions (for example work or education), transparency, informed consent, and ethical guidelines are essential.
Further reading and research on the GHQ-28 References
For a deeper understanding of the GHQ-28 and its psychometric properties, the following sources are useful:
- Goldberg, D. P., & Hillier, V. F. – original articles introducing and analyzing the General Health Questionnaire.
- Standardization and validation studies of the GHQ-28 in different countries and cultural contexts.
- Databases such as PubMed, PsycINFO, and Google Scholar for recent research using the GHQ-28 in various populations.
In research use, it is important to specify the exact version, scoring method (binary vs. Likert), and cut-off values appropriate for the population being studied.
Start the GHQ-28 Take the Test
If you would like a broad snapshot of your current mental health, you can complete the GHQ-28 and see how you are doing across the four main domains of psychological wellbeing and distress.
Start the GHQ-28 test