Different cutoff points for different trimesters? The use of Edinburgh Postnatal Depression Scale and Beck Depression Inventory to screen for depression in pregnant Taiwanese women
Different cutoff points for different trimesters? The use of Edinburgh Postnatal Depression Scale and Beck Depression Inventory to screen for depression in pregnant Taiwanese women
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DOI：
10.1016/j.genhosppsych.2007.05.005
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发表时间：
2007-09-01
影响因子：
7
通讯作者：
Pariante, Carmine M.
中科院分区：
文献类型：
--
作者：
Su, Kuan-Pin;Chiu, Tsan-Hung;Pariante, Carmine M.
目的：与产后抑郁症相比，验证自我报告问卷以检测怀孕期间的抑郁症，得到的关注要少得多。此外，目前还不清楚是否适合使用相同的截止点来检测不同孕期的抑郁症。本研究以台湾孕妇为研究对象，目的为：（a）验证台湾版爱丁堡产后忧郁量表（EPDS-T）与第二版贝克忧郁量表（BDI-II）的效度;（B）比较EPDS-T与BDI-II在忧郁症诊断上的效度;以及（c）确定这些量表在不同孕期检测重性抑郁障碍时是否有不同的截断点。185名完成EPDS-T和BDI-II的台湾孕妇接受精神科医生的结构性访谈，使用迷你国际神经精神访谈（MINI）建立精神障碍诊断和统计手册，第四版抑郁症的诊断。结果：EPDS-T以12/13为界值，其敏感性为83%，特异性为89%。BDI-II的最佳临界值为11/12，在此临界值下，量表的敏感性为74%，特异性为83%。EPDS-T和BDI的受试者工作特征分析曲线下面积分别为0.92和0.84。在不同的妊娠期，EPDS-T检测抑郁症的最佳截止点不同：中期妊娠为13/14，晚期妊娠为12/13。没有不同的最佳临界点BDI-II被发现为不同trimesters.Conclusion：EPDS-T有令人满意的敏感性和特异性和更好的效度比BDI-II检测重度抑郁症在怀孕期间的台湾妇女。我们建议进行更多的研究，更大的样本量，以确认是否存在不同的截止点，在不同的孕期抑郁症的检测。(C)2007年爱思唯尔公司All rights reserved.
Objective: Validating self-reported questionnaires to detect depression during pregnancy, compared to depression during postpartum, has gained much less attention. Furthermore, it is unknown whether it is appropriate to use the same cutoff point to detect depression on different trimesters of pregnancy. The aims of this study, conducted in pregnant Taiwanese women, were: (a) to validate the Taiwanese version of the Edinburgh Postnatal Depression Scale (EPDS-T) and the second edition of the Beck Depression Inventory (BDI-II); (b) to compare the EPDS-T and the BDI-II on their validity in detecting depression; and (c) to determine if these scales have different cutoff points in detecting major depressive disorder for different trimesters.Method: One hundred eighty-five pregnant Taiwanese women who completed the EPDS-T and the BDI-II were interviewed by psychiatrists with the structural interview Mini-Intemational Neuropsychiatric Interview (MINI) to establish a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of major depressive disorder. We analyzed and compared the sensitivity, specificity and validity of the EPDS-T and the BDI-II against the MINI diagnosis on the second and third trimesters.Results: We identified 12/13 as the optimal cutoff of the EPDS-T, at which the sensitivity of the scale was 83% and the specificity was 89%. The optimal cutoff of the BDI-II was 11/12, at which the sensitivity of the scale was 74% and the specificity was 83%. The area under the curve of the receiver operating characteristic analysis was 0.92 for the EPDS-T and 0.84 for the BDI. There exist different optimal cutoff points of the EPDS-T for detecting major depression during different trimesters: 13/14 for the second trimester and 12/13 for the third trimester. No different optimal cutoff point for the BDI-II was found for different trimesters.Conclusion: The EPDS-T has satisfactory sensitivity and specificity and better validity than the BDI-II for detecting major depressive disorder during pregnancy in pregnant Taiwanese women. We suggest that more studies with larger sample sizes be performed to confirm if there exist different cutoff points in detecting depression for different trimesters of gestation. (C) 2007 Elsevier Inc. All rights reserved.