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우울장애를 선별하는 신뢰롭고 타당한 선별도구를 개발하는 것은 잠재적인 위험군이나 발병 초기단계 있는 사람에게 최적의 치료를 제공하기 위한 가장 첫 번째 과제이다. 이는 현대 정신건강 정책이 정신질환의 예방과 조기개입을 강조하는 흐름과도 일치한다. 현재까지 우울장애를 선별하는 다수의 도구들이 개발되어 왔으나, 해외 저작권 지불의 문제를 해결하고, 우울의 하위영역은 물론 자살위험과 조증, 불안 및 신체증상을 포괄하며, 국가 연구 프로젝트와 병원 및 다양한 임상현장에서 활용할 수 있는 간결한 형태의 한국형 우울장애 선별도구를 개발하는 것이 과제로 남아있다. 본 연구에서는 현재까지 개발된 우울장애 선별도구를 체계적으로 개관하여 각 선별도구의 강점과약점을 분석하였으며 이를 바탕으로 새롭게 개발할 한국형 우울장애 선별도구(Korean Screening Tool for Depressive Disorders, K-DEP) 의 이론적 기초를 요약하였다. 임상심리, 정신의학, 심리측정 전문가 그룹으로 구성된 다학제 연구팀과 전문가 자문위원회와 함께 한국형우울장애 선별도구를 개발하는 과정을 요약하였으며, 이 과정에서 개발된 총 383문항의 예비 문항을 소개하고, 153명의 참여자에게 실시한 예비 분석결과를 제시하였다. 마지막으로 앞으로 실시될 한국형 우울장애 선별도구 개발 프로젝트의 차기 단계 과정과 고려사항들을논의하였다.
Developing a reliable and valid screening tool of depressive disorders is crucial to providing appropriate prevention and early interventions to potentially at-risk patients in the early stages. This viewpoint is similar to the new mental health paradigm initiated by the Ministry for Health & Welfare Affairs. Despite the existence of numerous screening tools for depressive disorders, the research group concluded that there is an urgent need to develop a new, valid depressive disorders screening tool that concisely and reliably measures key sub-domains of depressive disorders—suicidal risks, mania, anxiety, and somatic symptoms. As a preliminary step to pursuing this goal, we first conducted a systematic review of existing screening tools for depressive disorders, thoroughly analyzed the strengths and limitations of each tool, and summarized the theoretical foundations for the development of the new Korean screening tool for depressive disorders (K-DEP). Second, the research group introduced procedures for developing preliminary item pools for the K-DEP (a total of 383 items), administered it to 153 non-psychiatric patients, and summarized the results. Finally, we discussed the directions for the next steps in developing the K-DEP.
Ahn, Y. M., Lee, K. Y., Yi, J. S., Kang, M. H., Kim, D. H., Kim, J. L., . . . Chung, S. K. (2005). A validation study of the Korean-version of the Montgomery-Asberg depression rating scale. Journal of Korean Neuropsychiatric Association, 44, 466-476.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Publishing.
An, J. Y., Seo, E. R., Lim, K. H., Shin, J. H., & Kim, J. B. (2013). Standardization of the Korean version of screening tool for depression (Patient Health Questionnaire-9, PHQ-9). Journal of the Korean Society of Biological Therapies in Psychiatry, 19, 47-56.
Angst, J., Adolfsson, R., Benazzi, F., Gamma, A., Hantouche, E., Meyer, T. D., ... Scott, J. (2005). The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients. Journal of Affective Disorders, 88, 217-233.
Bae, J. N., & Cho, M. J. (2004). Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. Journal of Psychosomatic Research, 57, 297-305.
Bae, S. W., & Shin, W. S. (2005). The factor structure of the CES-D Scale (the Center for Epidemiologic Studies-Depression Scale):An application of confirmatory factor analysis. Health and Social Science, 18, 165-190.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897.
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996). Comparison of Beck Depression Inventories-IA and-II in psychiatric outpatients. Journal of Personality Assessment, 67, 588-597.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561.571
Cho, M. J., Bae, J. N., Suh, G. H., Hahm, B. J., Kim, J. K., Lee, D. W., & Kang, M. H. (1999). Validation of geriatric depression scale, Korean version (GDS) in the assessment of DSM-III-R major depression. Journal of Korean Neuropsychiatric Association, 38, 48-63.
Cho, M. J., Chang, S. M., Hahm, B. J., Chung, I. W., Bae, A., Lee, Y. M., . . . Bae, J. N. (2009). Prevalence and correlates of major mental disorders among Korean adults: a 2006 National Epidemiologic Survey. Journal of Korean Neuropsychiatric Association, 48, 143-152.
Cho, M. J., & Kim, K. H. (1993). Diagnostic validity of the CES-D (Korean version) in the assessment of DSM-III-R major depression. Journal of Korean Neuropsychiatric Association, 32, 381-399.
Choi, H. S., Choi, J. H., Park, K. H., Joo, K. J., Ga, H., Ko, H. J., & Kim, S. R. (2007). Standardization of the Korean version of Patient Health Questionnaire-9 as a screening instrument for major depressive disorder. Journal of the Korean Academy of Family Medicine, 28, 114-119.
Chon, K. K., Choi, S. C., & Yang, B. C. (2001). Integrated adaptation of CES-D in Korea. Korean Journal of Health Psychology, 6, 59-76.
Chon, K. K., & Rhee, M. K. (1992). Preliminary development of Korean version of CES-D. Korean Journal of Clinical Psychology, 11, 65-76.
Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150, 782-786.
Devine, J., Fliege, H., Kocalevent, R., Mierke, A., Klapp, B. F., & Rose, M. (2016). Evaluation of Computerized Adaptive Tests (CATs) for longitudinal monitoring of depression, anxiety, and stress reactions. Journal of Affective Disorders, 190, 846-853.
Ghaemi, S. N., Miller, C. J., Berv, D. A., Klugman, J., Rosenquist, K. J., & Pies, R. W. (2005). Sensitivity and specificity of a new bipolar spectrum diagnostic scale. Journal of Affective Disorders, 84, 273-277.
Hamilton, M. A. X. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278-296.
Han, K., Kim, M., & Park, J. M. (2004). The edinburgh postnatal depression scale, Korean version: Reliability and validity. Journal of Korean Society of Biological Therapies in Psychiatry, 10, 201-207.
Hathaway, S. R., & McKinley, J. C. (1942). A multiphasic personality schedule (Minnesota): III. The measurement of symptomatic depression. The Journal of Psychology, 14, 73-84.
Hirschfeld, R. M., Williams, J. B., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck Jr, P. E., . . . Russell, J. M. (2000). Development and validation of a screening instrument for bipolar spectrum disorder:the Mood Disorder Questionnaire. American Journal of Psychiatry, 157, 1873-1875.
Hoe, M. S., Park, B. S., & Bae, S. W. (2015). Testing Measurement Invariance of the 11-item Korean Version CES-D Scale. Mental Health & Social Work, 43, 313-339
Hung, C. I., Weng, L. J., Su, Y. J., & Liu, C. Y. (2006). Depression and somatic symptoms scale: A new scale with both depression and somatic symptoms emphasized. Psychiatry and Clinical Neurosciences, 60, 700-708.
Jon, D. I., Hong, N., Yoon, B. H., Jung, H. Y., Ha, K., Shin, Y. C., & Bahk, W. M. (2009). Validity and reliability of the Korean version of the Mood Disorder Questionnaire. Comprehensive Psychiatry, 50, 286-291.
Jung, I. K., Kwak, D. I., Joe, S. H., & Lee, H. S. (1997). A study of standardization of Korean form of Geriatric Depression Scale (KGDS). Journal of Korean Geriatric Psychiatry, 1, 61-72.
Jung, I. K., Kwak, D. I., Shin, D. K., Lee, M. S., Lee, H. S., & Kim, J. Y. (1997). A reliability and validity study of geriatric depression scale. Journal of Korean Neuropsychiatric Association, 36, 103-112.
Jung, S. W., Lee, E. J., Choi, Y. K., Sung, H. M., Kim, D. H., Choi, J. S., & Kim, J. B. (2009). A Guide of Diagnostic Evaluation for Depression -Focused on Assessment Instrument for Depression. The Korean Journal of Psychopathology, 18, 21-38.
Jung, S. Y., Kim, S. H., Park, K. H., Jaekal E. J., Lee, S. W., Choi, Y. Y., Lee, W. H., & Choi, K. H. (2017) A systematic review of validation studies on depression rating scales in Korea, with a focus on diagnostic validity information: Preliminary study for development of Korean Screening tool for Depression. Anxiety and Mood., 13, 1-7.
Jung, S., Lee, S. M., Lee, Y. S., & Lee, M. S. (2011). Development of a Short Form of the MMPI Scale 2 using Full-Information Item Factor Analysis. Korean Journal of Psychology: General, 30, 811-830.
Keller, M. B. (1994). Depression: A long-term illness. The British Journal of Psychiatry, 165, 9-15.
Kim D. H., & Kim J. B. (2006) Screening for depression in primary care. Korean Journal of Family Medicine, 27, 163-169.
Kim, J. I. (2006). A validation study on the translated Korean version of the Edinbergh postnatal depression scale. Korean Journal of Women Health Nursing, 12, 204-209.
Kim, J. S. (1992). A study on anxiety-depression and psycnoticism in hospitalized patients. Yeungnam University Journal of Medicine, 9, 54-67.
Kim, J. Y., Park, J. H., Lee, J. J., Huh, Y., Lee, S. B., Han, S. K., . . . Woo, J. I. (2008). Standardization of the Korean version of the Geriatric Depression Scale: Reliability, validity, and factor structure. Psychiatry Investigation, 5, 232-238.
Kim, K. W., Hong, J. P., Park, S. J., Choi, J. H., & Choi, H. R. (2011). Reliability and validity of Korean version of Depression and Somatic Symptom Scale (DSSS). Anxiety and Mood, 7, 15.
Kim, M. S., Lee, I. S., & Lee, C. S. (2007). The validation study 1 of Korean BDI-2: In female university students sample. Korean Journal of Clinical Psychology, 26, 997-1014.
Kim, Y. K., Hur, J. W., Kim, K. H., Oh, K. S., & Shin, Y. C. (2008). Clinical application of Korean version of edinburgh postnatal depression scale. Journal of Korean Neuropsychiatric Association, 47, 36-44.
Kroenke, K., Spitzer, R. L., Williams, J. B., Monahan, P. O., & Löwe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317-325.
Lee, H., & Kim, K. H. (2014). Validation of the Korean Version of the Mood and Anxiety Symptom Questionnaire (K-MASQ). Korean Journal of Clinical Psychology, 33, 395-411
Lee, J. B., Kim, C. S., Park, H. B., Park, B. T., Lee, J. H., & Cheung, S. D. (1987). A study on anxiety-depression in college freshmen. Yeungnam University Journal of Medicine, 4, 29-38.
Lee, J. H. (1995). Development of the Korean form of Zung's selfrating depression scale. Yeungnam University Journal of Medicine, 12, 292-305.
Lee, M. S., & Rhee, M. K. (2003). A development of Korea depression scale. Journal of Korean Neuropsychiatric Association, 42, 492-506.
Lee, S. A., Kim, K. H., & Cho, S. M. (2015). Validation of the Mood and Anxiety Symptom Questionnaire in Korean adolescents. Psychiatry Investigation, 12, 218-226.
Lee, S. C., Kim, W. H., Chang, S. M., Kim, B. S., Lee, D. W., Bae, J. N., & Cho, M. J. (2013). The use of the Korean version of short form Geriatric Depression Scale (SGDS-K) in the community dwelling elderly in Korea. Journal of Korean Geriatric Psychiatry, 17, 36-42.
Lee, Y. H., & Song, J. Y. (1991). A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales. Korean Journal of Clinical Psychology, 10, 98-113.
Lim, K. H., Park, Y. N., Kim, D. H., Shin, I. H., Lee, W. S., & Kim, J. B. (2009). A preliminary study of the standardization of the Korean version of the patient health questionnaire-9. Korean Journal of Health Promotion, 9, 275-281.
Lim, S. Y., Lee, E. J., Jeong, S. W., Kim, H. C., Jeong, C. H., Jeon, T. Y., . . . Kim, J. B. (2011). The validation study of Beck Depression Scale 2 in Korean version. Anxiety and Mood, 7, 48-53.
Louise B. Russell, & Milbank Memorial Fund. (1994). Educated guesses: Making policy about medical screening tests. Okland, CA:University of California Press.
Magovcevic, M., & Addis, M. E. (2008). The Masculine Depression Scale: Development and psychometric evaluation. Psychology of Men & Masculinity, 9, 117-132.
Mislevy, R. J., & Riconscente, M. M. (2005). Evidence-centered assessment design: Layers, structures, and terminology (Principled Assessment Designs for Inquiry Technical Report 9). Menlo Park, CA: SRI International.
Montgomery, S. A., & Asberg, M. A. R. I. E. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 134, 382-389.
Musselman, D. L., Evans, D. L., & Nemeroff, C. B. (1998). The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Archives of General Psychiatry, 55, 580-592.
Oh, M. Y., Angst, J., Sung, T. H., Lee, E. H., Hong, K. S., & Lee, D. S. (2009). Reliability and validity of the Hypomania Symptom Checklist-32 in Korea. Korean Journal of Clinical Psychology, 28, 321-338.
Oh, S. M., Min, K. J., & Park, D. B. (1999). A comparison of normal, depressed and anxious groups: A study on the standardization of the hospital anxiety and depressed scale for Koreans. Journal of Korean Neuropsychiatric Association, 38, 289-296.
Park, H. S., Jung, D., Jak, Y., Lee, C. I., Oh, J. E., Hong, S. H., & Cho, C. Y. (2006). Comparing various short-form geriatric depression scales in elderly patients. Journal of the Korean Academy of Family Medicine, 27, 364-369.
Park, S. C., Kim, J. M., Jun, T. Y., Lee, M. S., Kim, J. B., Yim, H. W., & Park, Y. C. (2017) How many different symptom combinations fulfill the diagnostic criteria for Major Depressive Disorder? Results from the CRESCEND Study. Nordic Journal of Psychiatry, 71, 217-222.
Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., Mulrow, C. D., & Lohr, K. N. (2002). Screening for depression in adults: A summary of the evidence for the US Preventive Services Task Force. Annals of Internal Medicine, 136, 765-776.
Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
Rhee, M. K., Lee, Y. H., Jung, H. Y., Choi, J. H., Kim, S. H., Kim, Y. K., & Lee, S. K. (1995). A standardization study of Beck Depression Inventory 2-Korean Version (K-BDI): Validity-II. Korean Journal of Psychopathology, 4, 96-104.
Sanislow, C. A., Pine, D. S., Quinn, K. J., Kozak, M. J., Garvey, M. A., Heinssen, R. K., . . . Cuthbert, B. N. (2010). Developing constructs for psychopathology research: Research domain criteria. Journal of Abnormal Psychology, 119, 631.
Seoul National University College of Medicine & Ministry for Health & Welfare Affairs. (2011). The Epidemiological Survey of Mental disorders in Korea. Retrieved from http://www.mohw.go.kr/
Shin, H. C., Kim, C. H., Park, Y. W., Cho, B. L., Song, S. W., Yun, Y. H., & Ou, S. W. (2000). Validity of Zung’s self-rating depression scale: Detection of depression in primary care. Journal of the Korean Academy of Family Medicine, 21, 1317-1330.
Shin, S. C., Kim, M. K., Yun, K. S., Kim, J. H., Lee, M. S., Moon, S. J., . . . Yoo, K. J. (1991). The center for epidemiologic studies-de pression scale: Its use in Korea. Journal of Korean Neuropsychiatric Association, 30, 752-767.
Spitzer, R. L., Kroenke, K., Williams, J. B., & Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Journal of the American Medical Association, 282, 1737-1744.
Steer, R. A., Ball, R., & Ranieri, W. F. (1999). Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. Journal of Clinical Psychology, 55(1), 117-128.
Suls, J., & Bunde, J. (2005). Anger, anxiety, and depression as risk factors for cardiovascular disease: the problems and implications of overlapping affective dispositions. Psychological Bulletin, 131, 260-300.
Sung, H. M., Kim, J. B., Park, Y. N., Bai, D. S., Lee, S. H., & Ahn, H. N. (2008). A study on the reliability and the validity of Korean version of the Beck Depression Inventory-II (BDI-II). Journal of the Korean Society of Biological Therapies in Psychiatry, 14, 201-212.
Toulmin, S. E. (1958). The uses of argument. Cambridge: Cambridge University Press.
Wang, H. R., Kim, S., Kang, S. H., Joo, Y. H., & Kim, C. Y. (2008). The validation study of the Korean version of the Bipolar Spectrum Diagnostic Scale. Journal of Korean Neuropsychiatric Association, 47, 533-539.
Whooley, M. A., Avins, A. L., Miranda, J., & Browner, W. S. (1997). Case-finding instruments for depression. Journal of General Internal Medicine, 12, 439-445.
Woo, S. B., & Yang, E. J. (2014). The validation of the Korean Masculine Depression Scale. The Korean Journal of Human Development, 21, 115-132.
World Health Organization. (2008). The Global Burden of Disease 2004 update. Retrieved from http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf
World Health Organization. (2016). Depression Fact Sheet. Retrieved from http://www.who.int/mediacentre/factsheets/fs369/en/
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
Yi, J. S., Bae, S. O., Ahn, Y. M., Park, D. B., Noh, K. S., Shin, H. K., ... Kim, Y. S. (2005). Validity and reliability of the Korean version of the Hamilton Depression Rating Scale (K-HDRS). Journal of Korean Neuropsychiatric Association, 44, 456-465.
Yook, S. P., & Kim, Z. S. (1997). A clinical study on the Korean version of Beck Anxiety Inventory: Comparative study of patient and non-patient. Korean Journal of Clinical Psychology, 16, 185-197.
Yu, B. K., Lee, H. K., Lee, K. S. (2011). Validation and factor structure of Korean version of the Beck Depression Inventory Second Edition (BDI-II): In a university student sample. Journal of Korean Society of Biological Psychiatry, 18, 126-133.
