證驗Greene更年期症狀量表之憂鬱分量表篩檢憂鬱症的適用性:以北部某醫學中心為例

Feasibility of Using Depression Scores of Greene Climacteric Scale to Screen Depression: The case of A Medical Center in Taoyuan City

羅可倩(Chloe Lo)

指導教授 ： 陳端容

共同指導教授 ： 劉嘉逸

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2017年)

https://doi.org/10.6342/NTU201700495

摘要

更年期是不可避免的一個生命過程，已有許多研究證明停經過渡期和憂鬱症狀增加之間的關聯。由於更年期個體經歷差異很大，故更年期整合門診為時勢所趨，症狀評量表在更年期整合門診頗有助益，目前婦產科及精神科在臨床或研究更年期症狀時，常使用Greene更年期症狀量表來評估更年期症狀，只是在評估更年期症狀時常需併用憂鬱症狀量表以評量憂鬱症狀，若Greene更年期症狀量表之憂鬱分量表足以反映個案憂鬱嚴重度，即可用單一自填量表同時評量更年期症狀及憂鬱嚴重度，因此在臨床及研究上，特別是臨床，將更為方便。綜上所述，此研究的目的是希望能證明Greene更年期症狀量表之憂鬱分量表足以篩檢出憂鬱個案。

本研究以Greene更年期症狀量表及MINI國際神經精神醫學會談問卷為工具，針對北部某醫學中心之婦女身心醫學門診求診的個案進行評估調查，有效問卷共計215份，以SPSS 18.0進行資料分析。

研究結果發現經由醫師診斷患有憂鬱症之受試者在Greene更年期等各項症狀的情況皆明顯高於沒有憂鬱症之受試者。以達醫師診斷為憂鬱症為效標，探討Greene更年期症狀之憂鬱分量表在評估憂鬱症之最佳切點分數為5分，其ROC曲線下的面積 ± 標準誤為 0.883 ± 0.028，說明了在本研究樣本中，Greenee更年期症狀之憂鬱分量表中以5分做為篩選更年期婦女是否患有憂鬱症之評估標準最為適合。

根據本研究之結果認為可採用Greene更年期症狀之憂鬱分量表作為簡易篩檢更年期婦女憂鬱症狀的工具，並以5分作為最理想之切點分數。未來在臨床上甚或應用到社區，可考慮採用Greene更年期症狀量表之憂鬱分量表進行評估更年期婦女的憂鬱症狀，即可快速篩檢並視情況處理或轉介。

關鍵字

更年期 ； 憂鬱 ； Greene更年期量表 ； MINI國際神經精神醫學會談問卷

並列摘要

Menopause is an inevitable life process. A number of studies proof that the positive association between depression and menopausal symptoms. Menopause integrated clinic is the trend of the times because the experience of menopause varies widely for each individual. Symptoms scales are helpful in the menopause integrated clinic. The Greene climacteric scale is often used as the tool to assess menopausal symptoms. However, the other depressive symptom scale needs to be used to measure depressive symptoms. If the depression subscale of Greene Climacteric Scale is sufficient to reflect the depression severity of the case, it can be used to measure menopausal symptoms and depression severity at the same time. Therefore, it will be more convenient in clinical and research, especially in clinical. The purpose of this study is to assess the feasibility of using depression scores of Greene climacteric scale to screen depression.

The participants were 215 patients who visited the menopause-related mood clinic in a medical center in north Taiwan. The study use the Greene climacteric scale and the Mini-International Neuropsychiatric Interview as the tool, and the SPSS 18.0 for analysis.

The results indicate that the subjects diagnosed with depression by psychiatrists were significantly higher in all subscales of the Greene Climacteric Scale than those without depression. Using the Mini-International Neuropsychiatric Interview as the standard of comparison, the ROC analysis suggests that the depression subscale of Greene Climacteric Scale score of 5 or more can be used as an optimal cutoff point for identifying depression. AUC ± standard error (SE) = 0.829 ± 0.036.

The results demonstrate that the depression subscale of Greene Climacteric Scale is a reliable and valid instrument for evaluating depression among menopause women, and 5 and above are optimal cutoff scores. The depression subscale of Greene Climacteric Scale can be used to quickly screen for menopausal women with depressive symptoms in clinical or even applied to the community.

並列關鍵字

Menopause ； Depression ； Greene Climacteric Scale ； Mini-International Neuropsychiatric Interview

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