Lloyd-Williams M, Friedman T, Rudd N
Leicestershire Hospice, Leicester General Hospital, Leicester, United Kingdom.
J Pain Symptom Manage. 2000 Oct;20(4):259-65. doi: 10.1016/s0885-3924(00)00182-2.
It is estimated that 25% of palliative care patients will have identifiable symptoms of depression. Near the end of life, the distinction between what can be called "appropriate sadness" and depression may be difficult. Many palliative care units use rating scales to help identify patients who may be depressed. It is believed that symptoms such as guilt, worthlessness, and hopelessness may be more discriminating than other symptoms for depression within this population. The Edinburgh postnatal depression scale (EPDS) was devised for use in women in the postnatal period and does not contain any somatic-type symptoms. It consists of 10 items, each rated on a four-point scale, and includes items on guilt, thoughts of self-harm, and hopelessness. It has not previously been used for screening in cancer patients. In a study of 100 inpatients receiving palliative care, a cutoff of 13 on the EPDS had a sensitivity of 81% and a specificity of 79% for detecting cases of depression. There was a low rate of misclassifications. This study suggests that the EPDS may be useful as a screening instrument for palliative care patients.
据估计，25%的姑息治疗患者会有可识别的抑郁症状。在生命末期，区分所谓的“适当悲伤”和抑郁可能很困难。许多姑息治疗病房使用评定量表来帮助识别可能抑郁的患者。据信，诸如内疚、无价值感和绝望感等症状，对于该人群中的抑郁症患者来说，可能比其他症状更具鉴别性。爱丁堡产后抑郁量表（EPDS）是为产后女性设计的，不包含任何躯体类型的症状。它由10个项目组成，每个项目按四点量表评分，包括关于内疚、自我伤害想法和绝望感的项目。此前它尚未用于癌症患者的筛查。在一项对100名接受姑息治疗的住院患者的研究中，EPDS评分13分的临界值对检测抑郁症病例的敏感度为81%，特异度为79%。错误分类率较低。这项研究表明，EPDS可能作为姑息治疗患者的筛查工具有用。
