英文女性中一般健康问卷 12 与爱丁堡产后抑郁量表的评分方法和阈值比较。
Comparison of scoring methods and thresholds of the General Health Questionnaire-12 with the Edinburgh Postnatal Depression Scale in English women.
机构信息
Department of Epidemiology and Public Health, University College London (UCL), 1-19 Torrington Place, London WC1E 6BT, UK.
出版信息
Public Health. 2009 Dec;123(12):789-93. doi: 10.1016/j.puhe.2009.09.012. Epub 2009 Nov 17.
OBJECTIVES
To compare the scoring methods and thresholds of the 12-item General Health Questionnaire (GHQ-12) and the Edinburgh Postnatal Depression Scale (EPDS) in English women, and to determine which threshold and scoring method provides the closest correlation of caseness of postnatal depression in a nationally representative sample of English women.
STUDY DESIGN
Health Survey for England 2002 health examination survey.
METHODS
Self-completion booklet containing the EPDS and the GHQ-12. Participants were mothers with at least one child under 1 year of age at the time of interview.
RESULTS
Both the scoring method and cut-off affected the estimates of prevalence of postnatal depression in English women. The best threshold and scoring method for the GHQ-12 using sensitivity/specificity analysis against the EPDS was a standard scale with a cut-off of 3+. This matched the cut-off using the GHQ-12 mean scores. The cut-off using comparative prevalence of the GHQ-12 with the EPDS was higher at 4+. There was a significantly lower estimate of prevalence of postnatal depression at 4 months using the GHQ-12.
CONCLUSIONS
Care needs to be taken measuring postnatal depression. The GHQ-12 mean score cut-off matched the cut-off using sensitivity and specificity; this supports using the GHQ-12 mean scores as cut-offs. The standard scale was most closely correlated with the EPDS. Although there was strong correlation between the GHQ-12 and the EPDS, a significantly lower proportion of women were measured as having possible postnatal depression at 4 months using the GHQ-12. This may be due to the lack of a question on blame in the GHQ-12. Four months coincided with the duration of maternity leave entitlement and recommended age for weaning in 2002. These events may be particularly stressful for mothers, and practitioners need to be mindful of similar milestones for diagnosis if using the GHQ-12.
目的
比较 12 项一般健康问卷（GHQ-12）和爱丁堡产后抑郁量表（EPDS）在英国女性中的评分方法和阈值，并确定哪种阈值和评分方法最能反映英国女性产后抑郁症的发病情况。
研究设计
2002 年英国健康调查健康检查调查。
方法
自我填写的问卷包含 EPDS 和 GHQ-12。参与者是在接受采访时至少有一个 1 岁以下孩子的母亲。
结果
评分方法和截断值都影响了英国女性产后抑郁症的患病率估计。使用灵敏度/特异性分析对 EPDS 进行 GHQ-12 的最佳阈值和评分方法是标准量表，截断值为 3+。这与 GHQ-12 平均分的截断值相匹配。使用 GHQ-12 与 EPDS 的比较患病率的截断值更高，为 4+。使用 GHQ-12 时，产后 4 个月的抑郁症患病率估计明显较低。
结论
测量产后抑郁症需要谨慎。GHQ-12 平均分的截断值与灵敏度和特异性使用的截断值相匹配；这支持使用 GHQ-12 平均分作为截断值。标准量表与 EPDS 最密切相关。虽然 GHQ-12 和 EPDS 之间存在很强的相关性，但使用 GHQ-12 时，4 个月后有产后抑郁症可能的女性比例明显较低。这可能是由于 GHQ-12 中没有关于责备的问题。4 个月恰逢产假和 2002 年推荐的断奶年龄。这些事件对母亲来说可能特别有压力，如果使用 GHQ-12，医生需要注意类似的诊断里程碑。
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