Lee D T, Wong C K, Ungvari G S, Cheung L P, Haines C J, Chung T K
Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong.
Psychosom Med. 1997 Mar-Apr;59(2):207-10. doi: 10.1097/00006842-199703000-00014.
Psychiatric morbidity affects 48% to 51% of women who have miscarried. This study evaluated the utility of two sample and brief self-report questionnaires in screening psychiatric morbidity after miscarriage.
One hundred fifty-six subjects completed the 30-item General Health Questionnaire (GHQ), the Edinburgh Postnatal Depression Scale (EPDS), and the Beck Depression Inventory (BDI) 6 weeks after miscarriage. Then there was a blind assessment using the Structured Clinical Interview for DSM-III-R (SCID) to establish psychiatric diagnosis. The criterion validity of GHQ and EPDS were tested against this yardstick diagnosis and the concurrent validity against the BDI scores. The internal consistency of the scales was measured by Cronbach's alpha-coefficient.
Both GHQ and EPDS had good sensitivity and specificity in screening for psychiatric morbidity after miscarriage. The concurrent validity and the internal consistency of both scales were satisfactory. The EPDS could only identify those subjects with major depression. The GHQ was longer to perform, but was able to detect both anxiety and depressive disorders. Furthermore, the GHQ had better psychometric properties when compared with the EPDS.
These scales will be particularly useful for nonpsychiatric medical personnel. We recommend routine application of the GHQ 6 to 8 weeks after miscarriage to identify women who may require psychiatric management.
精神疾病发病率影响着48%至51%的流产女性。本研究评估了两种简短的自我报告问卷在筛查流产后精神疾病发病率方面的效用。
156名受试者在流产6周后完成了30项一般健康问卷（GHQ）、爱丁堡产后抑郁量表（EPDS）和贝克抑郁量表（BDI）。然后采用针对《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）的结构化临床访谈（SCID）进行盲法评估以确立精神疾病诊断。以该标准诊断检验GHQ和EPDS的效标效度，并以BDI得分检验同时效度。采用克朗巴赫α系数测量量表的内部一致性。
GHQ和EPDS在筛查流产后精神疾病发病率方面均具有良好的敏感性和特异性。两种量表的同时效度和内部一致性均令人满意。EPDS只能识别出患有重度抑郁症的受试者。GHQ完成时间较长，但能够检测出焦虑症和抑郁症。此外，与EPDS相比，GHQ具有更好的心理测量特性。
这些量表对非精神科医务人员尤为有用。我们建议在流产后6至8周常规应用GHQ，以识别可能需要精神科治疗的女性。
