한국판 Edinburgh Postnatal Depression Scale의 임상적 적용 = Clinical Application of Korean Version of Edinburgh Postnatal Depression Scale

다국어 초록 (Multilingual Abstract)

Objectives : The EPDS (Edinburgh Postnatal Depression Scale) is a lO-items self-report scale designed as a specific instmment to detect postnatal depression by Cox et al. (1987). This study was to determine the optimal cut-offpoint ofthe K-EPDS for postpartum depression in Korea.
Methods : The 239 pregnant women assessed their own psychiatric features with the Korean version of the Edinburgh Postnatal Depression Scale (K.-EPDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Rosenberg Self-Esteem Scale (RSES) and Marital Satisfaction Scale (MSS) at 6 months ofpregnancy, 1 week after delivery, and 6 weeks after delivery. Subjects above 9 points of K-EPDS at 6 week after delivery were interviewed with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to confirm postpartum depression.
Results : The prevalence of postpartum depression was 12.6% (30/239 pregnant women) in our study. The total scores of K-EPDS at 6 weeks after delivery were higher significantly than those of nonnal group. The score gap of K-EPDS between the depressed pregnant group and the normal pregnant group was increased after the delivery. However, there were no differences in the epidemiological characteristics and the BDI scores at 6 weeks after delivery between groups. Using the AUC (area under the curve), the optimal point to assess the postpartum depression was revealed as 6 weeks after delivery (AUC=85.8%) or 24 weeks of pregnancy (83.7%). The cut-offpoint of K-EPDS to detect postpartum depression among pregnant women was 9/10score of K-EPDS (AUC= 81.8%).
Conclusion : In the K-EPDS, cut-off score of 9/10 was optimal to assess the postpartum depression, and K-EPDS at 6 weeks of delivery was more useful than any other point of time. K-EPDS administrated during pregnancy may be a useful tool to find the vulnerability on the postpartum depression.

참고문헌 (Reference)

1 김중임, "한국판 에딘버러 산후우울측정도구의 타당성 연구" 여성건강간호학회 12 (12): 204-209, 2006

2 Kim YK, "Validation of the Korean version of Edinburgh Postnatal Depression Scale (K-EPDS)" 3 : 42-49, 2005

3 Carpiniello B, "Validation of the Edinburgh Postnatal Depression Scale in Italy" 18 : 280-285, 1997

4 Roy A, "Use of Edinburgh Postnatal Depression Scale in a North American population" 17 : 501-504, 1993

5 Harris B, "The use of rating scales to identify post-natal depression" 154 : 813-817, 1989

6 Harris B, "The use of rating scales to identify post-natal depression" 154 : 813-817, 1989

7 Stein A, "The relationship between post-natal depression and mother-child interaction" 158 : 46-52, 1991

8 Park YJ, "The predictors of postpartum depression" 34 : 722-728, 2004

9 Roach AJ, "The marital satisfaction scale: development of a measure for intervention research" 43 : 537-546, 1981

10 Boyce P, "The Edinburgh Postnatal Depression Scale: validation for an Australian sample" 27 : 472-476, 1993

11 Rosenburg M, "Society and the Adolescent Self-Image" Princeton University Press 1965

12 Fontaine KR, "Self-esteem, optimism, and postpartum depression" 53 : 59-63, 1997

13 O’Hara MW, "Rates and risk of postpartum depression-a meta analysis" 8 : 37-54, 1996

14 Ballard CG, "Prevalence of postnatal psychiatric morbidity in mothers and fathers" 164 : 782-788, 1994

15 Hopkins J, "Postpartum depression and postpartum adaptation: overlapping constructs?" 17 : 251-254, 1989

16 Yoshida K, "Postnatal depression in Japanese women who have given birth in England" 43 : 69-77, 1997

17 Whisman MA, "Mood reactivity to marital conflict: the influence of marital dissatisfaction and depression" 33 : 299-314, 2002

18 Cogill SR, "Impact of maternal postnatal depression on cognitive development of young children. Br Med J (Clin Res Ed)" 292 : 1165-1167, 1986

19 Kwon SM, "Differential roles of dysfunctional attitude and automatic thoughts in depression: An integrated cognitive model of depression" Queensland Univ 1992

20 Kim MJ, "Development of the Korean Form of the Test Anxiety Inventory" 2 : 32-42, 1991

21 Hahn OS, "Development of Korean version of structured clinical interview schedule for DSM-IV axis I disorder: interrater reliability" 39 : 362-372, 2000

22 Cox JL, "Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale" 150 : 782-786, 1987

23 Lee DT, "Detecting postnatal depression in Chinese women. Validation of the Chinese version of Edinburgh Postnatal Depression Scale" 172 : 433-437, 1998

24 Altshuler LL, "Course of mood and anxiety disorders during pregnancy and the postpartum period" 59 (59): 29-33, 1998

25 Beck AT, "An inventory for measuring depression" 4 : 561-571, 1961

26 Beck AT, "An inventory for measuring clinical anxiety: psychometric properties" 56 : 893-897, 1988

27 Lee IS, "An assessment of the validity of the marital satisfaction scale - Mss of Roach, Frazier, Bowden" Kyung Hee Univ 1986

28 Lee YH, "A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales" (10) : 98-113, 1991

29 Kumar R, "A prospective study of emotional disorders in childbearing women" 144 : 35-47, 1984

30 Cox JL, "A controlled study of the onset, duration and prevalence of postnatal depression" 163 : 27-31, 1993