Evaluation of the SHIFT-Depression® Inventory With a Sample of Australian Women, Demonstrating the Centrality of Gendered Role Expectations to Their Depression

To address the double fold incidence and prevalence rates of depression in women compared to men needs more than symptom management. In primary health care where time does not normally allow for thorough assessments of what causes or maintains depression, using a brief questionnaire is warranted. A means must be found to address system level barriers to care and the poor quality of life so many women experience. Using an online survey and mixed method design, initial evaluation of a measure developed to identify individual and contextual issues connected to depression in women, examined underlying factor structure. 266 depressed women aged 18 to 85yrs also completed the Centre for Epidemiological Studies Depression scale (CESD) and provided written commentary about any further issues. The SHIFT-Depression® Inventory analysis revealed five reliable underlying factors explaining 59% of the variance. The factors identified were; 'diminished self/feels powerless/focused on other's care'; 'financial problems, lacks access to healthcare, healthy food, housing, exercise’; 'relationship difficulties, loss/betrayal/abuse’; ‘women’s problems’ and 'lack of social support/feels isolated'. Analysis of participant’s comments found four groupings similar to the identified factors. This initial evaluation of the SHIFT-Depression® Inventory showed evidence of the multiple issues impacting on depressed women spanning the physical, intrapsychic, relational, social and contextual areas. The inventory provides preliminary assessment which can identify when more extensive questioning and referrals to various services may be appropriate. It could be used in primary health care settings when consultation times are brief, or as an adjunct to assessment in the mental health setting. peerReviewed publishedVersion

相较于男性，女性抑郁症的发病率与患病率均为男性的两倍，针对这一现状的干预不应仅局限于症状管理。在基层医疗卫生机构中，由于接诊时间通常不足以对抑郁症的诱因或维持因素开展全面评估，因此有必要采用简短问卷进行筛查。同时，必须找到可行方案，以破解医疗体系层面的照护障碍，并改善诸多女性所面临的生活质量低下问题。本研究采用在线调查与混合研究设计，针对一款专为识别女性抑郁症相关个体与情境因素而开发的评估工具开展初步评估，以检验其潜在因子结构。266名年龄介于18至85岁之间的抑郁症女性受试者同时完成了流调中心抑郁量表（Centre for Epidemiological Studies Depression Scale, CESD），并就其他相关问题提交了书面反馈。对SHIFT-Depression®量表的分析结果显示，其包含5个具有可靠性的潜在因子，可解释59%的总变异量。所识别出的因子分别为："自我价值感降低/感到无力/专注于照料他人"、"经济困境、难以获取医疗服务与健康食品、住房问题、缺乏运动"、"人际关系困境、创伤经历/背叛/虐待经历"、"女性专属问题"以及"社会支持匮乏/感到孤立无援"。对受试者书面反馈的分析结果显示，其可被划分为与上述因子相似的4个类别。本次对SHIFT-Depression®量表的初步评估结果表明，影响抑郁症女性的多重问题涵盖躯体、心理内部、人际关系、社会与情境等多个领域。该量表可提供初步评估结果，辅助判断何时需要开展更深入的问诊，以及是否需要将受试者转介至各类相关服务机构。其既适用于接诊时间紧张的基层医疗卫生场景，也可作为精神卫生评估场景中的辅助工具。本研究为经同行评审的正式发表版本。