목적: 본 연구는 산후우울증의 선별 척도간 일치도와 유병률을 알아보고, 관련 요인을 파악하기 위해 시행되었다.
연구 방법: 연구에 동의한 323명의 환자에게 산후 1주일째에 3 종류의 산후우울증 선별 검사와 개인 정보를 위한 설문을 시행하였으며, 산부인과 정보는 의무기록에서 얻었다. EPDS와 BDI에 공통으로 위험군인 경우를 산후우울증으로 정의하였고, 유병률, 검사간 일치도 및 관련요인을 파악하였다.
결과: 산후우울증 유병률은 19.8%, Kappa지수는 EPDS, BDI, QIDS-SR16에서 각각 0.803, 0.711, 0.395였다. 산후우울증 관련요인은 단순분석시 수유방법, 흡연력, 산전 불안/우울증상, 부모와의 거주, 결혼 만족도, 임신전 시부모와의 관계, 산후조리형태 등이, 로지스틱 회기분석 시 미숙아 분만, 조제분유 수유, 결혼 불만족, 전문직 남편, 산전 불안/우울 증상 등이 유의한 관련 요인으로 나타났다 (P<0.05).
결론: 산후 1주일째 2가지 선별 검사를 동시 이용하여 효과적으로 산후우울증 유병률을 파악하였으며, EPDS가 가장 높은 일치도를 나타내었다. 여러 관련 요인들이 파악되었고 향후 더욱 많은 연구가 필요하리라 생각된다.
Objective: This study was performed to assess agreements among screening tests, to estimate prevalence, and to identify related factors with postpartum depression.
Methods: For 323 women at 7 days postpartum, self-administered questionnaires were given including postpartum depression screening test such as EPDS, QIDS-SR16, BDI and questionnaires for their demographic and psycho-social information. Obstetric information were collected from medical records. Simultaneous positive cases in EPDS and BDI were defined as gold standard and used to estimate the prevalence of postpartum depression and agreements between 3 kind of screening test and gold standard. Related factors of postpartum depression were analysed by using SPSS.
Results: The prevalence of postpartum depression was 19.8% and the Kappa indices were 0.711 in BDI, 0.803 in EPDS, and 0.395 in QIDS-SR16. Feeding method, smoking history, antenatal anxiety/depression symptoms, residence status, marital satisfaction, relationship with husband's parents, and postpartum care method in univariate analysis and premature delivery (odds ratio: 2.9), formulated feeding (odds ratio: 3.8), marital dissatisfaction (odds ratio: 4.3), professional husband's occupation (odds ratio: 4.4), and antenatal anxiety/depression symptoms (odds ratio: 4.4) in the logistic regression analysis were significantly related to postpartum depression (P<0.05).
Conclusion: Simultaneous test of BDI and EPDS was effective to evaluate postpartum depression prevalence at 1-week postpartum and highly agree with EPDS. Significant related factors were defined and further prospective community-based studies are warranted.