Zhong Qiu-Yue, Gelaye Bizu, Rondon Marta B, Sánchez Sixto E, Simon Gregory E, Henderson David C, Barrios Yasmin V, Sánchez Pedro Mascaro, Williams Michelle A
Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru.
Arch Womens Ment Health. 2015 Dec;18(6):783-92. doi: 10.1007/s00737-014-0481-0. Epub 2014 Nov 5.
We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.
我们试图检验患者健康问卷-9(PHQ-9)和爱丁堡产后抑郁量表(EPDS)中两个自杀意念条目之间的一致性,评估孕妇中自杀意念的患病率,并评估自杀意念与产前抑郁症状的共现情况。在秘鲁利马的产前保健诊所对1517名孕妇进行了一项横断面研究。PHQ-9的第9项评估过去14天内的自杀意念,而EPDS的第10项评估过去7天内的自杀意念。这两个自杀意念条目具有较高的一致率(84.2%),但一致性中等(科恩kappa系数=0.42)。基于PHQ-9和EPDS,分别有15.8%和8.8%的参与者自杀意念筛查呈阳性。通过PHQ-9评估,有自杀意念的参与者中51%可能患有抑郁症。在产前保健诊所,无论有无抑郁症状的女性都需要进行自杀意念筛查。未来需要开展研究,以确定产前自杀行为的其他预测因素,确定自杀意念筛查的合适报告期时长,并评估对两个自杀意念条目回答呈阳性的个体中计划自杀和企图自杀高风险者的比例。