The GHQ-12 has been recommended as a reliable screening instrument for psychological distress in all clinical groups. The usefulness of the GHQ-12 was evaluated in individuals with significant facial disfigurement by examination of the impact of alternative scoring methods on case detection rates. The type of scoring method used had a significant impact on the relative prevalence of `cases'. However, examination of the receiver operating characteristics (ROC) of the alternative scoring methods revealed a good fit between methods. The use of the GHQ-12 as a screening instrument to determine psychological distress in individuals with facial disfigurement may be enhanced by inclusion of an appearance-specific measure in the screening schedule and by the adoption of one scoring method; the GHQ method
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