Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R)

한국판 역학연구 우울척도 개정판(K-CESD-R)의 표준화 연구

  • Lee, San (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Oh, Seung-Taek (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Ryu, So Yeon (Department of Preventive Medicine, Chosun University Medical School) ;
  • Jun, Jin Yong (National Center for Mental Health) ;
  • Lee, Kounseok (Department of Psychiatry, St. Andrew's Neuropsychiatric Hospital) ;
  • Lee, Eun (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine) ;
  • Park, Jin Young (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine) ;
  • Yi, Sang-Wook (Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine) ;
  • Choi, Won-Jung (Department of Psychiatry, National Health Insurance Service Ilsan Hospital)
  • 이산 (국민건강보험 일산병원 정신건강의학과) ;
  • 오승택 (국민건강보험 일산병원 정신건강의학과) ;
  • 류소연 (조선대학교 의과대학 예방의학교실) ;
  • 전진용 (국립정신건강센터) ;
  • 이건석 (성안드레아병원 정신건강의학과) ;
  • 이은 (연세대학교 의과대학 정신과학교실 및 의학행동과학연구소) ;
  • 박진영 (연세대학교 의과대학 정신과학교실 및 의학행동과학연구소) ;
  • 이상욱 (가톨릭 관동대학교 의과대학 예방의학교실) ;
  • 최원정 (국민건강보험 일산병원 정신건강의학과)
  • Received : 2016.03.08
  • Accepted : 2016.06.12
  • Published : 2016.06.30
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Abstract

Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

연구목적 역학연구 우울척도 개정판은 우울 증상을 평가하는 데에 유용성이 입증된 척도로 알려져 있으며 '정신장애의 진단 및 통계 편람 제4판(DSM-IV)'에 기술되어 있는 주요우울장애의 주요한 우울 증상들을 포괄하고 있다. 이 연구에서는 한국판 역학연구 우울척도 개정판을 제작하여 척도의 신뢰도, 타당도와 특성을 평가하고자 하였다. 방 법 DSM-IV의 진단기준에 근거한 MINI를 사용하여 주요우울증, 기분부전증, 달리 분류되지 않는 우울장애로 진단된 48명의 환자군과 48명의 정상 대조군이 연구에 참여하였다. 연구 참여자들은 한국판 역학연구 우울척도 개정판, 몽고메리-아스버그 우울증 평가척도, 우울증 선별척도, 단축형 우울증상 평가 척도, 상태-특성 불안척도를 포함한 척도검사를 시행하여 교차 검증하였다. Cronbach's alpha 계수, Pearson 상관계수, 주성분 분석, Receiver Operating Characteristic(ROC) 곡선, 최적 절단점 산출을 위한 통계분석을 시행하였다. 결 과 한국판 역학연구 우울척도의 Cronbach's alpha 계수는 0.98이었으며, 한국판 역학연구 우울척도 개정판의 총점은 본 연구에서 시행하였던 다른 우울 및 불안척도의 점수와 높은 상관 관계를 보였다. 주성분 분석에서는 두 요인이 전체 분산의 76.29%를 설명하였으며, ROC 곡선을 이용하였을 때, 한국판 역학연구 우울척도 개정판의 최적 절단점은 13점이었다. 결 론 본 연구는 한국판 역학연구 우울척도 개정판의 표준화를 위한 첫 번째 연구로, 한국판 역학연구 우울척도는 우울 증상을 평가하는데 있어 신뢰성 있고, 타당한 척도임을 밝혔다. 또한 이 척도가 진료 및 역학 연구에서 유용한 선별검사 도구로 사용될 수 있을 것으로 기대한다.

Keywords

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