Chen Xinning, Hu Weihong, Hu Yao, Xia Xian, Li Xiaotian
Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Shanghai Mental Health Center, Shanghai, China.
J Psychosom Obstet Gynaecol. 2022 Mar;43(1):26-34. doi: 10.1080/0167482X.2020.1770221. Epub 2020 Jun 4.
The applicability of the Zung self-rating depression scale (SDS) in pregnancy is unknown. We aimed to identify redundant items and evaluate the Zung SDS's structural validity.
Two samples of pregnant women were invited from two districts in Shanghai (Yangpu sample, = 6468 and Huangpu sample, = 402). The Yangpu sample was randomly split into YGroup1/2/3. Item's properties were evaluated the item response theory in YGroup1. Exploratory and confirmatory factor analyses were correspondingly executed in YGroup2 and YGroup3. Those items with discrimination parameter (α) lower than 0.65 or factor loading smaller than 0.4 were deleted from the scale. The final structure was validated in the Huangpu sample.
Items 4 (sleep), 7 (weight loss), 8 (constipation) and 9 (tachyarrhythmia) exhibited low discrimination power. Items 2 (diurnal variation), 5 (appetite), 10 (fatigue) and 19 (suicide idea) made a low contribution to all factors. A three-factor model was eventually constructed as cognitive (Items 14, 16, 17, 18 and 20), psychomotor (Items 6, 11 and 12) and affective (Items 1, 3, 13 and 15).
The Zung SDS needs modification before applied to pregnant women in China. The items describing the overlap symptoms of the physical change in pregnancy and mood disorder should be deleted.
尚不清楚zung自评抑郁量表（SDS）在孕期的适用性。我们旨在识别冗余项目并评估zung SDS的结构效度。
从上海两个区招募了两组孕妇样本（杨浦区样本，n = 6468；黄浦区样本，n = 402）。杨浦区样本被随机分为Y组1/2/3。在Y组1中采用项目反应理论评估项目属性。在Y组2和Y组3中分别进行探索性和验证性因素分析。量表中区分度参数（α）低于0.65或因子载荷小于0.4的项目被删除。最终结构在黄浦区样本中得到验证。
项目4（睡眠）、7（体重减轻）、8（便秘）和9（快速性心律失常）显示出较低的区分能力。项目2（昼夜变化）、5（食欲）、10（疲劳）和19（自杀观念）对所有因素的贡献较低。最终构建了一个三因素模型，即认知因素（项目14、16、17、18和20）、精神运动因素（项目6、11和12）和情感因素（项目1、3、13和15）。
zung SDS在中国应用于孕妇之前需要进行修改。应删除描述孕期身体变化和情绪障碍重叠症状的项目。
