효과적인 우울증 치료를 위한 임상평가도구 = Rating Scales for Measurement-Based Clinical Practice of Depression

다국어 초록 (Multilingual Abstract)

The goal of treatment for depression is remission, but many patients do not achieve complete remission, and few reach sustained remission. This article aims to introduce depression rating scales and to encourage using these scales for objective and accurate assessment of depressive symptoms. There are various depression rating scales which can be categorized into the observer-rated scales and the self-report scales; The observer-rated scales include Hamilton Depression Rating Scale, Montgomery-Åsberg Depression Rating Scale and the self-report scales include Beck Depression Inventory (BDI), BDI-II, Center for Epidemiologic Studies Depression Scale, Patient Health Questionnaire-9 (PHQ-9), Geriatric Depression Scale (GDS),GDS-15. Validated and standardized self-report scales such as BDI-II, PHQ-9 are cost-effective and useful when assessing many patients in limited time in daily clinic. Assessment of anxiety, somatic symptoms, drug adherence and using Clinical Global Impression Scale might be useful for the improvement of the depression care in the clinic.

국문 초록 (Abstract)

본 원고의 목적은 우울증상을 정량적으로 측정하는 증상 척도를 소개함으로써 임상 현장에서 우울증을 치료할 때나 임상연구에 활용할 수 있도록 하는 것이다.
일반적으로 우울증상 척도는 객관적 척도와 환자 본인에 의한 자기보고형 척도로 나뉜다. 임상가에 의한 객관적 척도에는 HDRS와 MADRS가 있으며, 자기보고형 척도로는 BDI, BDI-II, CES-D, PHQ-9,GDS, GDS-15등이 포함된다. 이 중에서 임상연구 및 현장에서 사용을 위해서는 각각의 장단점을 고려하여 선택하여야 한다. 국내의 실제 임상 현장에서는 BDI-II나 PHQ-9 등의 간단하지만 표준화되어 있는 측정도구가 유용하다. 임상적 평가 및 증상의 관해를 위한 치료적 판단을 위해서는 임상가의 판단을 포함한 CGI뿐 아니라, 환자의 불안증상과 신체화 증상도 포함한 증상평가도 유용하게 사용될 수 있다.

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