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Journal of the Korean Academy of Family Medicine 1997;18(12):1452-1460.
Published online December 1, 1997.
The Standardization of Korean-translated Goldberg's shart screening scale for Anxiety and Depression.
Jong Seung Kim, Yoo Seok Kim, Ga Young Lee, Tae Jin Park, Young Ho Lee, Bo Keum Kong, Ju Cheol Sim
한국어판 Goldberg 의 불안증 및 우울증 선별검사도구의 표준화
김종승, 김유석, 이가영, 박태진, 이영호, 공보금, 심주철
인제대학교 의과대학 부산백병원 가정의학과,정신과
Abstract
Background
: At present, there are many instruments to diagnose anxiety and depression. However, most of the instruments have a number of questions. Therefore, we have many diffi-culties in applying them to the primary care. The purpose of this study was to measure the reli-ability and the validity of a Korean-translated Goldberg's short screening scale for anxiety and depression, which were developed for screening of anxiety and depression in primary care.

Methods : 178 asymtomatic subjects and 58 patients(anxiety 15, depression 43) aged from 18 to 64 years old were selected. The patients were diagnosed by psychiatrist according to DSM-IV criteria. This study was performed for 3 month, from May to August 1996. The reliability of this instrument was measured by internal consistency reliability. The validity of this instrument was measured by three methods. The first method was the comparison of the score between the patients and the control group. The second method was to measure te relationships of this in-strument with the other instruments such as Self-rating Depression Scale and State-Trait Anxiety Inventory. The last method was to measure the relationship of this instrument with Comprehensive Global Assessment. In addition, we calculated the sensituvity and specificity at the cut off values.

Results : The Cronbach's α value was 0.736 for the anxiety and 0.749 for the depression. Goldberg anxiety scale was significantly associated with state in STAI(r=0.279, P<0.001), and trait in STAI(r=0.125, P<0.041). However, Goldberg depression scale was not sigficantly asso-ciated with SDS. Goldberg anxiety scale as well as Goldberg depression scale were significantly associated with CGA(r=0.433, P=0.001 ; r=0.695, P=0.001). The score of Goldberg anxiety scale was significantly higher in the anxious patients than in the control group(P=0.047). The score of Goldberg depression scale was significantly higher in the depressive patients than in the control group(P<0.001). For anxiety scale of Goldberg scale, the sensitivity and specificity was 60% and 68% at score 3. For depression scale of Goldberg scale, the sensitivity and the spe-cificity was 80% and 68% at score 2.

Conclusion : We concluded that the value of Cronbach's α in Goldberg scale was 0.736 for anxiety and 0.749 for depression. For the validity, the scores of Goldberg scale were higher in patient group than in asymptomatic group. However, the relationships of Goldberg scale with other screening instruments were variable. So further study for the validity of Goldberg scale is requested.
초록
연구배경 : 현재 우리 나라에서 불안 및 우울 정도를 검사하기 위해 쓰이고 있는 다양한 평가 도구들은 문항 수가 많아 일차 진료에서 적용하기에 어려운 면이 많다. 따라서 본 연구에서는 일차 진료에서 불안 및 우울 장애를 쉽게 선별할 수 있도록 개발된 Goldberg의 short screening scale for anxiety and depression을 표준화시켜 보고자 하였다.

방법 : 본 연구는 1996년 5월부터 8월까지 18세이상 64세이하의 무증상군 178명과 DSM-IV criteria로 정신과 의사가 진단한 환자군 58명(불안증 15명, 우울증 43명)을 대상으로 실시하였다. 본 연구의 신뢰도를 측정하기 위하여 내적 일치도를 구하였고, 타당도의 측정을 위하여 환자군과 정상군에서 설문도구의 점수를 비교하였고, 불안증에 대한 Goldberg scale과 Spielberg의 State-Trait Anxiety Inventory(STAI)의 상관관계 및 우울증에 대한 Goldberg scale과 Zung의 Self-rating Depression Scale(SDS)의 상관관계를 알아보았고, 질환의 심각도를 반영하는 Comprehen-sive Global Assessment(CGA)와 본 설문도구의 상관관계를 알아보았다. 끝으로 각 scale의 경계치에서 민감도 및 특이도를 구하였다.

결론 : 불안증에 관한 Goldberg 선별검사도구의 Cronbach's α는 0.736, 우울증에 관한 Goldberg 선별검사도구의 Cronbach's α는 0.749이었다. 불안증에 관한 Goldberg scale과 State in STAI간(r=0.279, P<0.001), 불안증에 관한 Goldberg scale과 Trait in STAI간(r=0.125, P=0.041)에 는 유의한 상관관계가 있었으나, 우울증에 관한 Goldberg scale과 SDS간에는 유의한 상관관계가 없었다. 무증상군에 비해 환자군에서 불안증에 대한 Goldberg scale점수 및(P=0.047), 우울증에 대한 Goldberg scale점수가 (P<0.001) 유의하게 높았다.

결론 : 본 연구 결과 Goldberg scale의 신뢰도는 불안증의 경우 Cronbach's α가 0.736, 우울증의 경우 0.749 이었고, 타당도의 경우 무증상군에 비해 환자군에서 각각의 점수가 유의하게 높았던 반면, 기존의 선별검사 도구와 유의한 관련이 있는 결과와 관련이 없는 결과가 같이 나와 향후 타당도에 대한 연구가 필요하다고 생각되었다.


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