Kim Kyoung-Min, Nam Sojeong, Choi Jae-Won, Jung A-Hyun, Hong Soon-Beom, Kim Jun Won, Kim Soo Yeon, Kim Eunji, Kim Jae-Won
1 Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine , Seoul, Republic of Korea.
2 Department of Psychiatry, Catholic University of Daegu School of Medicine , Daegu, Republic of Korea.
J Child Adolesc Psychopharmacol. 2018 May;28(4):285-292. doi: 10.1089/cap.2016.0183. Epub 2017 Aug 3.
The Children's Depression Rating Scale-Revised (CDRS-R) is a valid instrument for the assessment of depressive symptoms in youth, but this measure is yet to be validated in Korea. Thus, the present study aimed to evaluate the validity of the Korean version of the CDRS-R and to determine its factor structures.
This study included 66 youths between 12 and 17 years of age who participated as part of an ongoing study investigating biomarkers of the antidepressant response and suicidal events in depressed youth. At baseline, the participants were assessed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL), CDRS-R, Children's Depression Inventory (CDI), Beck Depression Inventory (BDI), Clinical Global Impressions-Severity (CGI-S), Children's Global Assessment Scale (CGAS), and Child Behavior Checklist (CBCL). Based on their diagnosis, each participant was assessed either five (major depressive disorder [MDD], n = 36) or two (non-MDD, n = 30) more times with the CDRS-R, CDI, BDI, CGI-S, and CGAS; thus, 306 assessments were included in the final analyses of the present study. Pearson's r and Cronbach's α values were used to determine validity and internal consistency, and exploratory factor analysis was performed to determine the factor structures of the Korean version of the CDRS-R.
The CDRS-R score was significantly correlated with scores on the K-SADS-PL depression subscale (r = 0.93, p < 0.01), CDI (r = 0.86, p < 0.01), BDI (r = 0.85, p < 0.01), CGI-S (r = 0.84, p < 0.01), and CGAS (r = -0.86, p < 0.01), indicating that this measure has strong criterion validity. In addition, the high correlation of the CDRS-R with the depression subscale of the CBCL (r = 0.67, p < 0.01) and lower correlations with the subscales of the CBCL that assess delinquent behavior, aggressive behavior, and externalizing problem support the discriminant validity of this instrument (r ≤ 0.50, p < 0.01). Internal consistency was high, as evidenced by a Cronbach's α of 0.91, and the exploratory factor analysis revealed that the Korean version of the CDRS-R comprised three factors as follows: subjective depressed mood, daily functional impairment, and observed depressive affect. These factors differed from those used in previous studies, which were performed with the English version of the CDRS-R.
This study of the Korean version of the CDRS-R provides initial promising data regarding its criterion validity, discriminant validity, internal consistency, and factor structures. These properties were significantly strong, which suggests that the Korean version of the CDRS-R is a valid and reliable instrument for the assessment of depressive symptoms in youth.
儿童抑郁评定量表修订版(CDRS-R)是评估青少年抑郁症状的有效工具,但该量表在韩国尚未得到验证。因此,本研究旨在评估韩文版CDRS-R的有效性,并确定其因子结构。
本研究纳入了66名年龄在12至17岁之间的青少年,他们是一项正在进行的研究的一部分,该研究旨在调查抑郁青少年的抗抑郁反应生物标志物和自杀事件。在基线时,使用儿童情感障碍和精神分裂症量表-目前和终生版(K-SADS-PL)、CDRS-R、儿童抑郁量表(CDI)、贝克抑郁量表(BDI)、临床总体印象-严重程度(CGI-S)、儿童总体评估量表(CGAS)和儿童行为清单(CBCL)对参与者进行评估。根据诊断结果,每位参与者再使用CDRS-R、CDI、BDI、CGI-S和CGAS进行五次(重度抑郁症[MDD],n = 36)或两次(非MDD,n = 30)评估;因此,本研究的最终分析纳入了306次评估。使用Pearson相关系数r和Cronbach's α值来确定有效性和内部一致性,并进行探索性因子分析以确定韩文版CDRS-R的因子结构。
CDRS-R得分与K-SADS-PL抑郁分量表得分(r = 0.93,p < 0.01)、CDI得分(r = 0.86,p < 0.01)、BDI得分(r = 0.85,p < 0.01)、CGI-S得分(r = 0.84,p < 0.01)和CGAS得分(r = -0.86,p < 0.01)显著相关,表明该量表具有很强的效标效度。此外,CDRS-R与CBCL抑郁分量表的高相关性(r = 0.67,p < 0.01)以及与CBCL中评估违纪行为、攻击行为和外化问题的分量表的较低相关性支持了该工具的区分效度(r ≤ 0.50,p < 0.01)。内部一致性较高,Cronbach's α为0.91,探索性因子分析表明韩文版CDRS-R包含三个因子,分别为:主观抑郁情绪、日常功能损害和观察到的抑郁情绪。这些因子与之前使用英文版CDRS-R进行的研究中所使用的因子不同。
本研究对韩文版CDRS-R的研究提供了关于其效标效度、区分效度、内部一致性和因子结构的初步有前景的数据。这些特性非常显著,这表明韩文版CDRS-R是评估青少年抑郁症状的有效且可靠的工具。