Validation of the Dutch Greene Climacteric Scale in a clinical sample of women with severe menopausal symptoms.

OBJECTIVES

To evaluate the psychometric properties and latent factor structure of the Dutch Greene Climacteric Scale (GCS) in women with severe menopausal symptoms receiving secondary care.

METHODS

Using baseline data from the MOPP study (n = 195), confirmatory factor analyses (CFA) were conducted using a hypothesis-driven approach to test unidimensional, three-factor, and four-factor models of the GCS. Models were estimated using weighted least squares with mean and variance adjustment for ordinal item responses. Model fit was evaluated using multiple fit indices. Internal consistency was assessed using Cronbach's alpha.

MAIN OUTCOME MEASURES: Model fit indices, standardized factor loadings, factor correlations, and internal consistency estimates for GCS subscales and the total scale.

RESULTS

The four-factor structure showed the best fit, acceptable construct validity (CFI = 0.953; TLI = 0.945; SRMR = 0.097; RMSEA = 0.088), and high internal consistency (α = 0.71-0.85). Most item-factor loadings were adequate. Although moderate to high correlations between depression and anxiety (r = 0.77) and somatic and anxiety (r = 0.82) factors were found, discriminant validity remained acceptable.

CONCLUSION

The Dutch GCS is a valid and reliable instrument for monitoring menopausal symptoms and assessing treatment effects in clinical populations. While symptom domains show partial overlap, the total scale and its depressive, anxiety, somatic, and vasomotor subscales are suitable for symptom assessment and monitoring. Further validation in diverse clinical and community samples will enhance cross-population comparability and support broader implementation of the Dutch GCS in research and clinical practice.