Brief Depression Screener Developed Using IRT for Antenatal and Postpartum Women

描述(由申请人提供)：根据抑郁的标准、使用的评估类型和评估的时间，产前和产后抑郁的估计从7%到30%以上不等。因此，每年约有32万至100多万名妇女出现围产期抑郁症状。由于缺乏适当的诊断标准，对产前抑郁症的估计更难获得。尽管如此，目前还没有使用简洁、简单的语言和一致的反应选项集开发和测试产前和产后妇女的筛选器。该项目的总体目标是开发一种简短的筛查器来评估产前和产后妇女的抑郁症状。与现有的筛查器相比，建议的筛查器更容易让患者理解，花费的时间更少，心理测量学也更健康。在第一阶段，我们将开发大约30个专门针对产前和产后妇女抑郁的项目。我们将通过对10名产前和10名产后妇女的样本进行认知访谈来测试这些项目，以及我们之前开发的32个一般抑郁项目。专家们将回顾认知面试的结果，以建立将在第二阶段进行测试的项目库。第二阶段项目库将包括至少20个一般抑郁症项目，10个产前女性专用项目，以及10个产后女性专用项目。在第二阶段，500名产前和产后妇女(70%来自私营部门网站，30%来自公共部门网站)将完成EPDS(作为研究的筛查者)、BDI-II、PROMIS抑郁条目、OUR条目和SCID的抑郁模块。IRT将对这些数据进行分析，以开发7-9个项目筛选器。我们预计，这些项目中约有5-7项将适用于产前和产后妇女，其中约2-3项将是特定样本。开发的筛查器将被给予400名女性，她们将接受两次调查，间隔大约4-7天。这项研究将得出关于使用不同技术模式的筛查器的重测可靠性和患者满意度的结论。公共卫生相关性：孕妇和产后妇女的抑郁与不利的健康后果和精神病理有关，对这些妇女及其子女和家庭都是如此。拟议的项目旨在开发一种简单、有效的产前或产后抑郁症筛查方法，以便在定期医疗访问期间能够迅速识别患有抑郁症的妇女，并能够迅速开始接受适当的服务。拟议的筛查不仅将通过使用更简单、更简洁的语言，而且还将通过其开发过程改进现有措施，该过程需要直接收集孕妇和产后妇女的反应。

DESCRIPTION (provided by applicant): Estimates of antenatal and postpartum depression vary from 7 percent to upwards of 30 percent depending on criteria for depression, the type of assessment used, and the timing of the assessment. Thus, approximately 320,000 to over 1 million women each year experience symptoms of perinatal depression. Estimates of antenatal depression are harder to obtain because of the lack of appropriate diagnostic criteria. Despite this, no screener currently exists that has been developed and tested with both antenatal and postpartum women that uses concise, simple language, and a consistent response option set. The overall aim of this project is to develop a brief screener to assess depressive symptoms among antenatal and postpartum women. The proposed screener will be easier for patients to understand, will take less time, and will be more psychometrically sound than current screeners. In Phase I we will develop approximately 30 items that are specific to depression in antenatal and postpartum women. We will test these items using cognitive interviewing among a sample of 10 antenatal and 10 postpartum women in addition to 32 general depression items we have previously developed. Experts will review the results of the cognitive interviewing to develop the item pool that will be tested in Phase II. The Phase II item pool will consist of at least 20 general depression items, 10 items specific to antenatal women, and 10 items specific to postpartum women. In Phase II, 500 antenatal and 500 postpartum women (70 percent from private sector sites and 30 percent from public sector sites) will complete the EPDS (as a screener into the study), BDI-II, the PROMIS depression items, our items, and the depression module of the SCID. IRT analyses will be conducted on these data to develop a 7-9 item screener. We anticipate that approximately 5-7 of these items will be applicable to both antenatal and postpartum women and approximately 2-3 of these items will be sample specific. The developed screener will then be given to 400 women who will take the survey twice, approximately 4-7 days apart. Conclusions regarding test-retest reliability and patient satisfaction with taking the screener using different modes of technologies will be made from this study. PUBLIC HEALTH RELEVANCE: Depression among pregnant and postpartum women has been associated with adverse health outcomes and psychopathology, both for these women and for their children and families. The proposed project aims to develop a brief, efficient screener for antenatal or postpartum depression, so that women who are depressed can be identified quickly during regular healthcare visits and can begin to receive appropriate services promptly. The proposed screener would improve upon existing measures not only through use of simpler, more concise language, but also through its development process, which entails collecting responses from pregnant and postpartum women directly.