Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea.
Department of Prevention Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2021 Jul 12;36(27):e185. doi: 10.3346/jkms.2021.36.e185.
The frequencies of South Korean soldiers' depression and resulting suicide are increasing every year. Thus, this study aimed to develop and confirm the reliability and validity of a simple short form depression screening scale for soldiers.
This study was conducted as part of a 2013 research project named 'The Epidemiological Study on the Prevalence of Depression in Military Service and a Search for High Risk Group Management.' Clinical depression was diagnosed using the Korean version of the Mini International Neuropsychiatric Interview and suicide risk was assessed through the Korean version of the Composite International Diagnostic Interview. Furthermore, the Center for Epidemiological Studies for Depression Scale (CES-D), the Stress Response Inventory, and the Barret Impulsiveness Scale were employed. Of the 20 CES-D items, three of the most correlated items with clinical diagnosis were derived to form the short form scale. Analyses for internal consistency, concurrent validity, and factor analysis were implemented for its validation. We performed a receiver operating curve (ROC) analysis using a clinical diagnosis of depression as a gold standard to calculate the area under the curve (AUC) value, cut-off score, and corresponding sensitivity and specificity to that cut-off score.
According to the results of the correlation analysis, 7, 18, and 4 were selected to be on our scale. The three-item scale was reliable with a Cronbach's alpha value of 0.720, and a factor was derived from the factor analysis. The ROC analysis showed a high discriminant validity, with an AUC value of 0.891. The sensitivity and specificity were 84.8% and 78.2%, and 71.7% and 91.6%, respectively, for each when the selected cut-off scores were 2 and 3, respectively. Depression screened through the scale when the cut-off score was 2 or 3 was significantly associated with suicidality, stress, and social support.
The depression screening questionnaire for Korean soldiers developed through this study demonstrated high reliability and validity. Since it comprises only three items, it can be utilized easily and frequently. It is expected to be employed in a large-scale suicide prevention project targeting military soldiers in the future; it will be beneficial in selecting high-risk groups for depression.
韩国士兵的抑郁发生率和自杀率逐年上升。因此，本研究旨在为士兵开发并验证一种简单的抑郁筛查量表的信度和效度。
本研究是 2013 年一项名为“军事服役期间抑郁流行状况的流行病学研究和高危人群管理探索”的研究项目的一部分。使用韩国版迷你国际神经精神访谈（Mini International Neuropsychiatric Interview）诊断临床抑郁症，使用韩国版复合国际诊断访谈（Composite International Diagnostic Interview）评估自杀风险。此外，还使用了流行病学研究抑郁量表（Center for Epidemiological Studies for Depression Scale，CES-D）、应激反应量表（Stress Response Inventory）和巴雷特冲动量表（Barret Impulsiveness Scale）。在 20 个 CES-D 项目中，选取与临床诊断相关性最高的三个项目组成简短形式量表。对内部一致性、同时效度和因子分析进行分析，以验证其有效性。我们使用临床诊断的抑郁症作为金标准进行了接收者操作曲线（receiver operating curve，ROC）分析，以计算曲线下面积（area under the curve，AUC）值、截断值以及该截断值对应的灵敏度和特异性。
根据相关分析的结果，选择了 7、18 和 4 作为量表项目。三项目量表具有可靠性，克朗巴赫 α 值为 0.720，因子分析得出一个因子。ROC 分析显示，其具有较高的判别效度，AUC 值为 0.891。当选择的截断值分别为 2 和 3 时，灵敏度和特异性分别为 84.8%和 78.2%，71.7%和 91.6%。当量表的截断值为 2 或 3 时，筛选出的抑郁与自杀意念、应激和社会支持显著相关。
本研究开发的韩国士兵抑郁筛查问卷具有较高的信度和效度。由于它只包含三个项目，因此可以方便且频繁地使用。预计在未来针对军事人员的大型自杀预防项目中会用到它，这对选择抑郁高危人群会有帮助。
