한국판 정신장애 진단 선별 질문지의 표준화 연구

Study on Standardization of Korean Version of Psychiatric Diagnostic Screening Questionnaire(K-PDSQ)

  • 최형근 (계명대학교 의과대학 동산의료원 정신건강의학교실) ;
  • 정성원 (계명대학교 의과대학 동산의료원 정신건강의학교실) ;
  • 조현주 (영남대학교 의과대학 심리학교실) ;
  • 김정범 (계명대학교 의과대학 동산의료원 정신건강의학교실) ;
  • 정철호 (계명대학교 의과대학 동산의료원 정신건강의학교실)
  • Choi, Hyeong-Keun (Department of Psychiatry, Keimyung University School of Medicine, KeiMyung University Hospital) ;
  • Jung, Sung-Won (Department of Psychiatry, Keimyung University School of Medicine, KeiMyung University Hospital) ;
  • Jo, Hyun-Ju (Department of Psychology, Yeungnam University School of Medicine) ;
  • Kim, Jeong-Bum (Department of Psychiatry, Keimyung University School of Medicine, KeiMyung University Hospital) ;
  • Jung, Chul-Ho (Department of Psychiatry, Keimyung University School of Medicine, KeiMyung University Hospital)
  • 투고 : 2013.03.05
  • 심사 : 2013.04.15
  • 발행 : 2013.04.30

초록

정신장애 진단선별 질문지(PDSQ)는 임상에서 흔하게 진단되는 DSM-IV 축 1의 장애를 평가하기위해 고안된 최초의 자기보고식 질문지이다. PDSQ는 포괄적인 평가가 가능하고, 공존질환을 평가 할 수 있으며 신뢰도와 타당도가 높은 것으로 알려져 있다. 이 연구는 K-PDSQ의 표준화를 위한 연구로서, K-PDSQ와 M.I.N.I.-Plus의 비교를 통해 K-PDSQ의 진단적 타당성과 유용성을 검증하고자 하였다. 계명대학교 동산병원 정신건강의학과를 방문한 외래와 입원환자 640명을 대상으로 K-PDSQ와 M.I.N.I.-Plus의 진단적 일치도, K-PDSQ의 시행시간, 민감도 및 특이도를 산출하였다. K-PDSQ와 M.I.N.I.-Plus의 Cohen's kappa계수는 .66로 일치도가 높게 나타났고, K-PDSQ의 시행 소요시간은 $18.2{\pm}11.80$분이었다. 타당도에 있어 국내 환자군 대상으로 산출된 절단점을 적용하였을 때 높은 수준의 민감도와 특이도를 나타냈다. 대부분의 하위척도에서 수용자 작업특성 곡선(ROC)이 대각선 위에 있었고 곡선아래 영역(AUC) 값이 .80 이상으로 선별검사로서 유용성이 입증되었다. K-PDSQ는 M.I.N.I.-Plus와 상당한 진단적 일치도를 보였고, 시행시간이 짧고, 민감도와 특이도에서 높은 수준을 보였다. 따라서 K-PDSQ는 외래 진료환경에 적용하여 임상면담 이전에 환자에 대한 진단적 평가와 공존질환을 선별해내는데 큰 도움이 될 것으로 생각된다.

Objective : The PDSQ is a brief and psychometrically strong self-report scale designed to screen for common DSM-IV Axis I disorders in clinical settings. In this study, the K-PDSQ was compared with the M.I.N.I.-Plus (Mini-International Neuropsychiatric Interview-Plus) for diagnostic validity and availability of the K-PDSQ as a part of standardization of the K-PDSQ. Methods : The 640 patients were evaluated with the K-PDSQ and the M.I.N.I.-Plus. Diagnosing with the M.I.N.I.-Plus, the diagnostic correspondence, administering time, sensitivity, specificity, ROC curve, and AUC of the K-PDSQ were evaluated. Results : For the diagnostic correspondence of the K-PDSQ, Cohen's kappa coefficient was .66 between the K-PDSQ and the M.I.N.I.-Plus. The administering time of the K-PDSQ was $18.2{\pm}11.80$ minutes. Both sensitivity and specificity of the K-PDSQ were higher: the mean sensitivity across 10 subscales of K-PDSQ was 86%; the mean specificity was 84%. All AUCs of each subscale were above .80, which were statistically significant. Conclusion : The K-PDSQ is valid and available as a diagnostic screening tool. It will be widely used in clinical settings for screening DSM-IV Axis I diagnosis because of its simplicity and high reliability.

키워드

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