VALIDASI KLINIK GENERAL HEALTH QUESTIONNAIRE-12 (GHQ-12) SEBAGAI INSTRUMEN SKRINING GANGGUAN OBSESIF KOMPULSIF DI PUSKESMAS

Devita Septiani Nursalim, Rahmat Hidayat, M.Sc., Ph.D.

2014 | Tesis | S2 Magister Profesi Psikologi

Literatur menunjukkan bahwa Gangguan Obsesif Kompulsif atau OCD merupakan salah satu subtipe dalam Gangguan Kecemasan yang sering terdiagnosis. Akan tetapi, belum ada instrumen skrining di layanan kesehatan primer atau Puskesmas yang valid, reliabel, sensitiv, dan spesifik untuk mendeteksi OCD. Oleh karena itu, banyak pasien dengan OCD tidak mendapatkan penanganan yang tepat. Penelitian ini bertujuan untuk menguji validitas klinik dari GHQ-12 sebagai instrumen skrining OCD di Puskesmas. Structured Clinical Interview for DSM IV Disorder-Axis I (SCID-I) digunakan sebagai standar emas. Responden adalah 227 pasien dewasa, usia 18-60 tahun, dari 10 Puskesmas di Sleman dan Kota Yogyakarta, Provinsi Yogyakarta. Koefisien reliabilitas Alpha Cronbach memuaskan menurut metode skoring GHQ atau bimodal, Likert, dan CGHQ (0.855, 0.868, 0.851 berturut-turut). Principal Component Analysis menunjukkan bahwa GHQ-12 terdiri dari dua komponen, yaitu “distres psikologis” dan “disfungsi sosial”. Receiver Operating Curve (ROC) and Likelihood Ratio (LR) digunakan untuk menganalisis validitas kliniknya. Hasil penelitian menunjukkan bahwa GHQ-12 berdasarkan metode skoring Likert (AUC=75,6%, titik potong optimal ≥4, sensitivitas=80%, spesifisitas=69,3%, LR+=2,61, LR-=0,29) dapat digunakan sebagai instrumen skrining untuk OCD di Puskesmas.

Obsessive Compulsive Disorder (OCD) is considered as one of subtype in anxiety disorder, which frequently diagnosed. However, there is no valid, reliable, sensitive, and specific screening instrument available in primary health care, to detect OCD. Therefore, many patient with OCD did not get the appropriate treatment. This study aimed to examine the clinical validity of GHQ-12 as screening instrument for OCD in primary health care. Structured Clinical Interview for DSM IV Disorder-Axis I (SCID-I) used as gold standard. The respondent were 227 adult outpatients, aged 18-60, from 10 primary health care in Sleman and Kota Yogyakarta, Yogyakarta Province. Alpha Cronbach reliability coefficient were satisfactory according to Bimodal, Likert, and CGHQ scoring methods (0.855, 0.868, and 0.851 respectively). Principal Component Analysis showed that GHQ-12 consist of two components, that is “psychological distress” and “social disfunction”. Receiver Operating Curve (ROC) dan Likelihood Ratio (LR) were conducted to assess the clinical validity. Result showed that GHQ-12 based on Bimodal scoring method (AUC=75,6%, optimum cut-off ≥4, sensitivity=80%, specificity=69,3%, LR+=2,61, LR-=0,29) can be used as screening instrument for OCD in primary health care.

Kata Kunci : GHQ-12, Gangguan Obsesif Kompulsif, layanan kesehatan primer (Puskesmas), validitas klinik, skrining