爱丁堡产后抑郁量表的临床应用

目的:初步探讨Edinburgh产后抑郁量表（EPDS）用于中国妇女的临床用．量表性能及适宜的分界值。方法：298名产妇在产后第三天用EPDS、BDI、GHQ进行评定,抽取部分产妇用DSM－Ⅲ－R临床试验式检查－住院版（SCID－NP）进行调查,以建立DSM－Ⅲ－R抑郁障碍的诊断。结果：EPDS和BDI、GHQ具有良好的平行效度。以BDI量表分和DSM－Ⅲ－R诊断结果为标准,其临床筛查分界值应为9／10。结论：EPDS具有良好的临床使用性能,是筛查产后抑郁简便而敏感的量表,推荐其分界值为9／10。     

在离休干部中所见的抑郁症

对356名离休干部用老年期抑郁量表进行调查，有47名超过11分，其中41名符合DSM－Ⅲ-R抑郁发作之诊断标准，患病率为11．5％，疾病类型有：内因性4例，隐匿性6例，反应性31例，共有18例的发病诱因与离休直接有关。     

睡眠障碍与产后抑郁症之间的关联

目的 评估女性产后睡眠障碍和产后抑郁症的发生率,并探讨产后睡眠障碍对产后抑郁 症发生的影响。方法 采用横断面的研究设计,对2017 年1 月至2018 年12 月于解放军空军军医大学西 京医院进行分娩后复查的252 名产妇进行基础资料调查。采用匹兹堡睡眠质量量表（PSQI）和爱丁堡产 后抑郁量表（EPDS）评估睡眠质量和产后抑郁症状。EPDS ＞ 9.5 分定义产后抑郁症,根据产妇产后是否 发生抑郁症,将252 名产妇分为产后抑郁组与非抑郁组。结果 本研究中产妇睡眠障碍和产后抑郁症 的发生率分别为36.1%（91/252）和25.8%（65/252）。单因素分析中,产后抑郁组产妇PSQI 总分显著高于 非抑郁组［（8.43±2.37）分比（5.76±1.84）分;t=9.293,P＜ 0.01］;除睡眠时间分量表外,产后抑郁组PSQI 各分量表得分均高于非抑郁组产妇（均P＜ 0.01）;产后抑郁组产妇睡眠障碍（PSQI ＞ 7 分）发生率明显高 于非抑郁组产妇［52.3%（34/65）比30.5%（57/187）;χ2=9.960,P=0.002］。多因素Logistic 回归分析结果显 示,在调整了社会人口统计学变量、围产期变量和妊娠期疾病变量后,产后睡眠质量和产后抑郁症之间 的关联仍然显著（OR=2.35,95%CI：1.32～4.21）。结论 产后睡眠障碍与产后抑郁症存在正向关联,对 于存在产后睡眠障碍的产妇,应尽早提供干预措施,以减少抑郁症的发生风险。     

高龄孕产妇焦虑、抑郁症状分析

目的：探讨高龄孕产妇焦虑、抑郁症状的发生率及相应的危险因素。方法：随机选取两家妇产科医院的孕妇522名,采用综合医院焦虑和抑郁量表（HAD）、爱丁堡产后抑郁量表（EPDS）和自编危险因素问卷,分别评估人组时、孕38周、产后7d、产后42d和产后3个月的焦虑、抑郁症状。结果：522名中有19例高龄孕产妇。高龄孕产妇5个时点的焦虑症状发生率依次为：15.8％、11．1％、21．1％、6．7％和10．0％;孕期HAD评定的抑郁症状发生率为21．1％、11.1％,产后EPDS评定抑郁症状发生率为10.5％、28．6％和20．0％。高龄孕产妇焦虑、抑郁症状的发生率均高于非高龄孕产妇。初潮年龄和担忧孩子喂养与高龄孕产妇人组时的抑郁情绪相关,分娩时紧张状态和产后抢救与产后7d的焦虑情绪相关。结论：高龄孕产妇存在较多的焦虑和抑郁情绪,应针对其危险因素进行预防。     

产后抑郁与人新饱食分子蛋白1、瘦素、胃饥饿素的相关性

目的 探讨产后抑郁与人新饱食分子蛋白1(Nesfatin-1)、瘦素（Leptin,LP）、胃饥饿素（Ghrelin）的相关性。方法 本研究对象为2021年5月～2023年5月间收治的84例产妇,采用爱丁堡产后抑郁量表（Edinburgh postnatal depression scale,EPDS）进行产后抑郁评估,根据评估结果设为产后抑郁组以及无产后抑郁组。检测并比较两组患者血清Nesfatin-1、LP、Ghrelin水平,分析产后抑郁组EPDS评分与上述指标的相关性,采用受试者工作特征曲线（receiver operating characteristic curve,ROC）分析上述指标对产后抑郁的预测价值。结果 84例产妇产后抑郁28例,抑郁率33.33%;产后抑郁组血清LP、Ghrelin水平显著低于无产后抑郁组,Nesfatin-1水平显著高于无产后抑郁组,（P<0.05）;产后抑郁组EPDS评分与血清Ghrelin、LP水平具有负相关关系,与Nesfatin-1水平具有正相关关系（P<0.05）;血清Nesfatin-1、LP、Ghrelin预测产后抑郁...     

自主神经功能与产后抑郁的相关性分析

目的探讨妊娠期自主神经功能对产后抑郁的影响及相关性。方法以2015-06—2016-06在我院产科门诊建立产检保健卡的257例妊娠期妇女为研究对象进行前瞻性研究,所有妊娠妇女于妊娠12周内进行早期自主神经系统功能检查,并于产后42d给予爱丁堡产后抑郁量表(EPDS)进行产后抑郁评估,根据是否发生产后抑郁进行分组,并对临床资料和早期自主神经功能检测结果进行比较分析。结果 257例产妇中EPDS≥13分者39例(抑郁组),EPDS13分者218例(正常组),产后抑郁发生率为15.18%,组间比较,抑郁组与正常组在是否首胎、分娩方式、孕周方面差异具有统计学意义(P0.05);抑郁组SDNN、LF/HF比值明显低于正常组,而压力指数相比正常组明显增高(P0.05);SDNN与产后抑郁呈负相关,压力指数与产后抑郁呈正相关(P0.05)。结论妊娠早期进行常规自主神经功能检查对于筛查和干预产后抑郁有一定的指导作用。     

性激素、催乳素与产后抑郁的相关研究

目的：本研究主要探讨产后雌二醇（Ｅ２）、催乳素（ＰＲＬ）变化和产后抑郁症状间的关系。方法：对３８名产妇在产程开始前和产后第７２小时分别抽取血标本,使用放射免疫法检测产后Ｅ２、Ｐ和ＰＲＬ的数量变化,同时用Ｅｄｉｎｇｂｕｒｇｈ产后抑郁量表（ＥＰＤＳ）、Ｂｅｓｋ抑郁量表（ＢＤＩ）、一般健康问卷（ＧＨＱ）对产妇在产后第３天和产后第４２天进行评定。结果：产后第３天ＥＰＤＳ和ＢＤＩ量表分值显著高于产后第４２天,产后Ｅ２变化与ＥＰＤＳ、ＢＤＩ量表分呈显著负相关,产后Ｐ变化和产后第４２天ＧＨＱ量表分呈显著正相关,ＰＲＬ变化和产后情绪状况无明显关系。结论：产后内分泌激素变化可能是产后抑郁的病因之一。     

抑郁-焦虑-压力量表中文精简版在护理人员中信效度评价

目的评价抑郁-焦虑-压力量表中文精简版（DASS-C21）的信度和效度,为该量表在中国内地护理人群中的应用提供科学依据。方法采用随机抽样方法在长沙、郴州地区二、三级医院中抽取645例护理人员进行问卷调查;采用内部一致性信度、分半信度和建构信度进行信度评价,采用内容效度、效标关联效度和结构效度进行效度评价。结果（1）项目分析结果表明,DASS-C21各项目与总分有较高相关;（2）DASS-C21有较高的内部一致性信度、分半信度和建构信度;（3）DASS-C21有良好的效标关联效度、内容效度和结构效度。结论DASS-C21量表具有良好的信度和效度,可以作为中国内地护理人群心理健康状况的有效评价工具。     

共情能力与产后抑郁症状的相关性研究

目的:探讨共情能力与产后抑郁症状的相关性.方法:对1366例符合入组标准的产后42 d回院进行产后保健的产妇,按照自愿原则进行一般人口学资料的收集,并进行爱丁堡产后抑郁量表(EPDS)、人际反应指针问卷(IRI-C)自评;以EPDS≥9分为划界值将入组者分组及组间比较;分析EPDS评分与IRI-C评分间的关系.结果:共...     

利培酮治疗精神分裂症抑郁性障碍临床分析

目的：了解利培酮对精神分裂症抑郁障碍的疗效。方法：符合DSM－Ⅳ和CCMD－2－R精神分裂症诊断标准的患者,阳性和阴性症状量表（PANSS）评分＞60分,Montgomery-A Sberg抑郁量表评分（MADS）＞16分,共108例患者完成研究,其中利培酮组55例,舒必利组53例。结果：利培酮对精神病性症状的总有效率为72．7％,对抑郁症状的总有效率为74．6％,与舒必利组相比无明显差异,但利培酮对阴性症状及抑郁症状中的认知障碍和睡眠障碍的疗效明显好于舒必利。利培酮的副反应少于舒必利,结论利培酮对精神分裂症的阴性症状和抑郁症状均有较好的疗效。     

Postnatal psychiatric morbidity: a validation study of the GHQ-12 and the EPDS as screening tools

OBJECTIVE: To assess the validity of the 12-Item General Health Questionnaire (GHQ-12) and the Edinburgh Postnatal Depression Scale (EPDS) in screening for the most common postnatal psychiatric morbidities (mood, anxiety and adjustment disorders). METHOD: A two-phase cross-sectional study was designed. First, a sample of 1453 women visiting at 6 weeks postpartum completed the GHQ-12 and the EPDS questionnaires. Second, based upon EPDS outcomes, participants were stratified and randomly selected within each stratum for clinical evaluation [Structured Clinical Interview for DSM-IV (SCID)]. Receiver operating characteristic (ROC) analysis was used. RESULTS: The concurrent validity was satisfactory (0.80). At optimum cut-off scores, both GHQ-12 and EPDS yielded very good sensitivity (80; 85.5) and specificity (80.4; 85.3), respectively. ROC curves showed that the performance of the EPDS (AUC=0.933) is slightly superior to that of GHQ-12 (AUC=0.904). CONCLUSION: Both GHQ-12 and EPDS are valid instruments to detect postnatal depression as well as postnatal anxiety and adjustment disorders.     

An international study exploring levels of postpartum depressive symptomatology

OBJECTIVE: Differences in postpartum depressive symptomatology (PPDS) among an international sample of 892 women from nine countries representing five continents were explored. METHOD: Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) were used to assess PPDS among a convenience sample that completed the two questionnaires twice, yielding a total of four sets of scores per subject. Women sampled were primiparae with no obstetrical complications, and had a healthy baby. Depression history and therapy were ruled out as exclusion criteria. RESULTS: Mean scores for EPDS and BDI varied across sites at both time points (P value<.001). European and Australian women had the lowest levels of PPDS, USA women fell at the midpoint, and women from Asia and South America had the highest depressive symptom scores. The moderate concordance between the EPDS and BDI suggested that the measures have complementary uses for screening and assessment. CONCLUSION: Utility of EPDS and BDI for yielding profiles of postpartum women's depressive symptomatology was demonstrated. Further research to validate depressive symptom measures with diverse international populations is indicated.     

Screening for postnatal depression in routine primary care: properties of the Edinburgh Postnatal Depression Scale in an Australian sample

OBJECTIVES: First, to explore the utility of the Edinburgh Postnatal Depression Scale (EPDS) in routine primary care through a large community screening program. Next, to compare administration of a second EPDS versus the Beck Depression Inventory (BDI) in identifying postnatal depression in the prescreened population. METHOD: Screening with the EPDS through Maternal and Child Health Centres at 4 months post-partum. Women scoring > or = 12 were assessed against DSM-IV criteria and completed a BDI and a second EPDS. These data were subjected to receiver operating characteristic (ROC) analyses. RESULTS: Of 4148 screened, 533 (12.8%) scored > or = 12. Of these, 344 were assessed against DSM-IV criteria: 193 (56%) - major depressive disorder; 67 (20%) - other diagnoses that incorporated depression. Positive predictive value at screening was therefore 76%. Another 45 (13%) had non-depressive disorders and 39 (11%) were psychiatric non-cases. The BDI was the better diagnostic instrument in the prescreened population, having a significantly higher efficiency as quantified by ROC curve analysis, though the absolute difference in efficiency was small (approximately 6%). CONCLUSIONS: Screening with the EPDS integrated well into routine primary care. Two-step screening offers one way of achieving acceptable balances of operational simplicity and diagnostic accuracy.     

Initial validation of the Chinese interRAI Mental Health in people with psychiatric illness

Objective. The purpose of this study was to determine the reliability and validity of the Chinese interRAI Mental Health (MH) among people with psychiatric illnesses. Methods. Study participants were 157 individuals with psychiatric illnesses living in a psychiatric long-term care facility or halfway house in Hong Kong. The authors prepared the Chinese interRAI MH. A panel of bilingual healthcare professionals examined the quality of the translation. The reliability of the 6 scales embedded in the instrument was examined using Cronbach's alphas, intraclass correlations, and Kappa coefficients. Pearson's product moment correlations, Spearman's order correlations, and independent t-tests were used to determine the concurrent and construct validity of the scales. Results and Conclusions. Internal consistency values (α = 0.66–0.95) and test–retest reliability coefficients (ICC = 0.76–0.97; κ = 0.75–1.00) of the scales were found to be satisfactory. All 6 scales correlated significantly with the criterion measures. As expected, 3 scales relating to cognition, activities of daily living (ADL), and instrumental ADL discriminated among individuals living in two types of residential setting. Chinese interRAI MH was found to be a valid and reliable tool useful for the clinicians in Hong Kong.     

A review of the validity of the General Health Questionnaire in adolescent populations

OBJECTIVE: To comprehensively review the validity of the General Health Questionnaire (GHQ) [1] with adolescents (aged 12-19). Although the GHQ has been extensively used and validated with adults and has been frequently used with adolescents, the validity data for this group are sporadic. METHOD: Systematic review of the English language peer-reviewed literature. RESULTS: Eight studies were identified validating the GHQ with young people of which four included only adolescents and four studies involved young adults and adolescents. Of these eight studies, four used an English language version of the GHQ and four used a translated version. CONCLUSION: The GHQ has demonstrated validity with older adolescents (17 + years) from the UK and Hong Kong (Chinese translation) and with girls aged 15 in the UK, but there are few data for either gender, aged less than 15 years. Studies in Australia and Italy reported a high proportion of misclassified cases while the studies in Spain and Yugoslavia included some older subjects (20 + years). Therefore, the validity of the GHQ for adolescents in populations other than the UK and Hong Kong remains to be demonstrated. IMPLICATIONS: Psychiatrists and other mental health professionals need to be aware of the above limitations when using the GHQ as a screening instrument with adolescents. Further studies are required to: (i) determine the minimum age at which it can be employed, (ii) compare the use of adult versus adolescent criterion interviews, (iii) assemble relevant normative data, and (iv) establish the validity of translated versions.     

The Beck Depression Inventory and General Health Questionnaire as measures of depression in the general population: a validation study using the Composite International Diagnostic Interview as the gold standard

The Beck Depression Inventory (BDI) and the General Health Questionnaire (GHQ) are commonly used in population studies as measures of depression. We examined in a population sample the validity of four scales for depressive symptoms, the GHQ-12, the 21- and 13-item versions of the BDI, and a new 6-item version of the BDI developed for this study. A total of 5561 participants in the "Health 2000" survey (30-79 years) completed the four scales and were assessed with the Composite International Diagnostic Interview (CIDI), which was used as the validation criterion. We selected items for the BDI-6 through an exploratory factor analysis for the BDI-21. The accuracy of the scales, including the BDI-6, was satisfactory (c-statistics 0.88-0.92 for depression within the past 2 weeks and 0.80-0.83 within the past 12 months) and slightly better for men (0.92-0.96 and 0.85-0.87) than for women (0.86-0.88 and 0.78-0.79). Higher scores in all the scales were associated with more severe depression and more recent depressive episodes. This study suggests that various versions of the BDI and the GHQ-12 are useful in detecting depressive disorders in the general population. Even the 6-item version of the BDI showed acceptable criterion validity, although replication in an independent dataset is needed to confirm its validity.     

Validation of a German version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)

IntroductionGoal of the present study was the validation of a German version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E).Methods197 adult epilepsy patients completed the NDDI-E (185 completed both the NDDI-E and BDI). 95 patients received psychiatric consults.Results33 patients received a diagnosis of major depression according to ICD-10 criteria. Internal consistency of the NDDI-E was .83. Receiver operating characteristics (ROC) showed an area under the curve of 0.92. Applying a cutoff score of ≥ 14 resulted in both sensitivity and specificity of 0.85. In the subsample with psychiatric consult, at the same optimal cutoff, sensitivity was 0.92, and specificity was 0.86. Further analyses showed a high concurrent validity with the BDI.DiscussionThe German version of the NDDI-E constitutes a brief and reliable depression screening instrument for epilepsy patients.     

Usefulness of Beck Depression Inventory (BDI) in the Korean elderly population

OBJECTIVES: This study aimed to evaluate the diagnostic validity of the Beck Depression Inventory (BDI) in the elderly and to suggest an optimal cut-off score in order to screen major depressive disorder. METHODS: The BDI and an elderly health questionnaire were administered to 2729 subjects over the age of 60 chosen by stratified random sampling in a Ansan City, South Korea. The BDI and geriatric depression scale (GDS) were examined at about a two-year interval. A reliability and validity test, a factor analysis and an ROC curve analysis were performed. RESULTS: Eighty-four subject had depression and 2645 subjects were rated as normal. The BDI showed significant positive internal consistency (r = 0.88) and test-retest reliability (r = 0.60). Convergent validity with GDS was significantly positive (r = 0.59), and an exploratory factor analysis revealed four factors. We suggest a score of 16 as the optimal cut-off point for the BDI when screening for major depression. CONCLUSION: The results of this study showed that the Korean version of the BDI is appropriate for screening for depression and 16 is the optimal cut-off score for the Korean elderly. Screening of elderly depression with BDI in the community would be valuable when comparing with younger adults and with their former BDI data which were taken when they were young.     

The Inventory for Depressive Symptomatology (IDS): preliminary findings

The Inventory for Depressive Symptomatology (IDS) is a new measure of depressive signs and symptoms. Both self-report and clinician-rated versions are under development. The IDS-SR (self-report) was completed by 289 patients, 285 of whom were outpatients. Unipolar major depression (n = 174), bipolar disorder (n = 44), euthymic (S/P unipolar or bipolar) depression (n = 33), and other psychiatric disorders (n = 38) were included. The IDS-SR had good internal reliability (coefficient alpha = 0.85), and significantly correlated with both the Hamilton Rating Scale for Depression (HRSD) (r = 0.67) and the Beck Depression Inventory (BDI) (r = 0.78). The clinician-rated IDS (IDS-C) was administered to 82 outpatients (75 with unipolar or bipolar disorder, 5 with other psychiatric disorders, and 2 euthymic (S/P unipolar) depressions). Coefficient alpha (0.88) suggested strong internal consistency. The IDS-C correlated highly with both the HRSD (r = 0.92) and the BDI (r = 0.61). Discriminant and factor analyses provided evidence for construct validity for both the IDS-C and IDS-SR. Both scales significantly differentiated endogenous from nonendogenous depression defined by Research Diagnostic Criteria (RDC). Factor structures for the IDS-SR revealed four factors: mood/cognition, anxiety, selected endogenous symptoms, and hyperphagia-hypersomnia. The IDS appears applicable to both inpatients and outpatients with endogenous, atypical, and nonendogenous major depression, and may have utility with dysthymics.