\u3010\u6587\u732e\u540d\u3011
\n\u2028Beck A, et al. Severity of depression and magnitude of productivity loss. Ann Fam Med. 2011;9(4):305-311.\u2028\u2028<\/p>\n
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\n\u2028\uff1c\u76ee\u7684\uff1e
\n\u2028\u3046\u3064\u75c5\u306f\u4ed5\u4e8b\u306b\u304a\u3051\u308b\u52b4\u50cd\u6027\u306e\u4f4e\u4e0b\u3001\u3064\u307e\u308a\u3001\u4f11\u8077\u3001\u751f\u7523\u6027\u306e\u4f4e\u4e0b\u3001\u4ed5\u4e8b\u304c\u9577\u7d9a\u304d\u3059\u308b\u304b\u3068\u306e\u95a2\u9023\u304c\u6df1\u3044\u3002\u305f\u3060\u3001\u5927\u898f\u6a21\u3067\u591a\u69d8\u306a\u60a3\u8005\u5c64\u306b\u304a\u3044\u3066\u3001\u91cd\u75c7\u5ea6\u306e\u7570\u306a\u308b\u3046\u3064\u75c5\u304c\u8077\u52d9\u3078\u306e\u969c\u5bb3\u306e\u7a0b\u5ea6\u306b\u3069\u306e\u3088\u3046\u306b\u95a2\u9023\u3057\u3066\u3044\u308b\u304b\u3092\u8abf\u3079\u305f\u7814\u7a76\u306f\u307b\u3068\u3093\u3069\u306a\u3044\u3002\u4eca\u56de\u3001\u3046\u3064\u75c5\u6cbb\u7642\u3092\u958b\u59cb\u3057\u305f\u60a3\u8005\u306b\u304a\u3051\u308b\u3046\u3064\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u3068\u751f\u7523\u6027\u4f4e\u4e0b\u306e\u95a2\u4fc2\u6027\u3092\u8a55\u4fa1\u3059\u308b\u3053\u3068\u3068\u3057\u305f\u3002<\/p>\n
\u2028\u2028\uff1c\u65b9\u6cd5\uff1e
\n\u2028\u30c0\u30a4\u30a2\u30e2\u30f3\u30c9\uff08DIAMOND\uff1aDepression Improvement Across Minnesota: Offering a New Direction\uff09\u30a4\u30cb\u30b7\u30a2\u30c1\u30d6\uff08\u5dde\u6c11\u767a\u6848\uff09\u3001\u3064\u307e\u308a\u3001\u5dde\u3092\u6319\u3052\u3066\u306e\u3046\u3064\u75c5\u30b1\u30a2\u306e\u5f37\u5316\u3092\u76ee\u7684\u3068\u3057\u305f\u8cea\u5411\u4e0a\u5354\u50cd\u6d3b\u52d5\u306b\u53c2\u52a0\u3059\u308b\u60a3\u8005\u304b\u3089\u30c7\u30fc\u30bf\u3092\u53d6\u5f97\u3057\u305f\u3002\u6297\u3046\u3064\u85ac\u3092\u65b0\u898f\u306b\u51e6\u65b9\u3055\u308c\u305f\u60a3\u8005\u306b\u3064\u3044\u3066\u3001PHQ-9\uff08Patient Health Questionnaire 9-item screen\uff09\u306b\u3066\u3046\u3064\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u3001WPAI\u8cea\u554f\u7d19\uff08Work Productivity and Activity Impairment\uff09\u306b\u3066\u751f\u7523\u6027\u306e\u4f4e\u4e0b\u3001\u66f4\u306b\u306f\u5065\u5eb7\u72b6\u614b\u3084\u57fa\u790e\u60c5\u5831\u306a\u3069\u3092\u8a55\u4fa1\u3057\u305f\u3002\u2028\u2028<\/p>\n
\uff1c\u7d50\u679c\uff1e\u2028
\n\u73fe\u5728\u52b4\u50cd\u3057\u3066\u3044\u308b771\u540d\u306e\u60a3\u8005\u304b\u3089\u306e\u30c7\u30fc\u30bf\u3092\u5206\u6790\u3057\u305f\u3002\u57fa\u790e\u60c5\u5831\u3084\u5065\u5eb7\u72b6\u614b\u3092\u88dc\u6b63\u3057\u305f\u4e00\u822c\u7dda\u5f62\u89e3\u6790\u3067\u306f\u3001\u3046\u3064\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u3068\u751f\u7523\u6027\u306e\u4f4e\u4e0b\u306e\u9593\u306b\u76f4\u7dda\u7684\u306a\u5f37\u3044\u95a2\u9023\u6027\u304c\u3042\u308a\u3001PHQ-9\u306e1\u70b9\u306e\u4e0a\u6607\u306b\u5bfe\u3057\u3066\u3001\u5e73\u5747\u30671.65%\u306e\u66f4\u306a\u308b\u751f\u7523\u6027\u4f4e\u4e0b\u304c\u8a8d\u3081\u3089\u308c\u305f\uff08P\uff1c0.001\uff09\u3002\u8efd\u5fae\u306a\u3046\u3064\u75c7\u72b6\u3067\u3055\u3048\u3082\u8077\u52d9\u80fd\u529b\u306e\u4f4e\u4e0b\u3068\u95a2\u9023\u3057\u3066\u3044\u305f\u3002\u30d5\u30eb\u30bf\u30a4\u30e0\u3068\u30d1\u30fc\u30c8\u30bf\u30a4\u30e0\u306e\u96c7\u7528\u5f62\u614b\u306e\u76f8\u9055\u3001\u81ea\u5df1\u5831\u544a\u306b\u3088\u308b\u52b4\u50cd\u72b6\u614b\u306e\u76f8\u9055\uff08\u307e\u3041\u307e\u3041\u3001\u60aa\u3044\u3000v.s. \u7d20\u6674\u3089\u3057\u3044\u3001\u975e\u5e38\u306b\u826f\u3044\u3001\u826f\u3044\uff09\u3082\u307e\u305f\u3001\u751f\u7523\u6027\u306e\u4f4e\u4e0b\u3068\u95a2\u9023\u3057\u3066\u3044\u305f\uff08\u5404p\uff1c0.001\u3068p\uff1d0.45\uff09\u3002\u2028\u2028<\/p>\n
\uff1c\u7d50\u8ad6\uff1e
\n\u2028\u3053\u306e\u7814\u7a76\u306b\u3088\u308a\u3001\u3046\u3064\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u3068\u8077\u52d9\u6a5f\u80fd\u306e\u9593\u306e\u95a2\u9023\u6027\u306f\u660e\u3089\u304b\u3067\u3042\u308a\u3001\u8efd\u5fae\u306a\u3046\u3064\u75c5\u3067\u3055\u3048\u3082\u751f\u7523\u6027\u4f4e\u4e0b\u3068\u95a2\u9023\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u793a\u5506\u3055\u308c\u305f\u3002\u96c7\u7528\u8005\u306b\u3068\u3063\u3066\u3001\u5e45\u5e83\u3044\u91cd\u75c7\u5ea6\u306e\u5e45\u3092\u6301\u3064\u3046\u3064\u75c5\u52b4\u50cd\u8005\u306b\u5bfe\u3057\u3066\u52b9\u679c\u7684\u306a\u6cbb\u7642\u3092\u63d0\u4f9b\u3059\u308b\u3053\u3068\u306f\u6709\u610f\u7fa9\u3067\u3042\u308d\u3046\u3002\u2028\u2028<\/p>\n
\u3010\u8003\u5bdf\u3068\u30c7\u30a3\u30b9\u30ab\u30c3\u30b7\u30e7\u30f3\u3011
\n\u2028\u3046\u3064\u75c5\u3068\u52b4\u707d\u3001\u7279\u306b\u81ea\u6bba\u3068\u306e\u95a2\u9023\u6027\u304c\u65e5\u672c\u3067\u306f\u3053\u3053\u6570\u5e74\u5f37\u8abf\u3055\u308c\u3001\u7523\u696d\u533b\u6d3b\u52d5\u3067\u3082\u91cd\u8996\u3055\u308c\u3066\u3044\u308b\u3002\u3082\u3061\u308d\u3093\u3001\u751f\u7523\u6027\u3078\u306e\u5f71\u97ff\u306f\u611f\u899a\u7684\u306b\u306f\u7406\u89e3\u3057\u3066\u3044\u308b\u3082\u306e\u306e\u3001\u3053\u3046\u3057\u305f\u5177\u4f53\u7684\u30c7\u30fc\u30bf\u3092\u78ba\u8a8d\u3057\u305f\u306e\u306f\u521d\u3081\u3066\u3067\u3042\u3063\u305f\u3002\u73fe\u5728\u306e\u8077\u5834\u3067\u306f\u6642\u9593\u5916\u52b4\u50cd\u6642\u9593\u306b\u3088\u3063\u3066\u6a5f\u68b0\u7684\u306b\u5bfe\u8c61\u8005\u304c\u9078\u5225\u3055\u308c\u3066\u3044\u308b\u304c\u3001\u5fc5\u305a\u3057\u3082\u52b4\u50cd\u6642\u9593\u3068\u95a2\u4fc2\u306a\u304f\u3001\u3046\u3064\u75c5\u306e\u521d\u671f\u75c7\u72b6\u3092\u793a\u3057\u3066\u3044\u308b\u65b9\u3092\u7a4d\u6975\u7684\u306b\u30d4\u30c3\u30af\u30a2\u30c3\u30d7\u3057\u3001\u7523\u696d\u533b\u9762\u8ac7\u3092\u53d7\u3051\u308b\u3088\u3046\u6d3b\u52d5\u3059\u308b\u3053\u3068\u306b\u610f\u7fa9\u304c\u3042\u308b\u3068\u4e88\u60f3\u3055\u308c\u308b\u3002\u5177\u4f53\u7684\u306b\u3001\u8077\u5834\u5185\u8b1b\u7fd2\u306a\u3069\u306e\u958b\u50ac\u3092\u8003\u3048\u3066\u307f\u305f\u3044\u3002<\/p>\n
\u2028The PHQ-9 is a depression assessment tool which scores each of the 9 DSM-IV criteria as ‘0’ (not at all) to ‘3’ (nearly every day):\u2028\u00a0
\nthe PHQ-9 assessment tool been validated for use in Primary Care\u2028
\nthe questionnaire is designed to assess the patient’s mood over the last 2 weeks:
\nover the last 2 weeks, how often have you been bothered by any of the following problems?
\n1) little interest or pleasure in doing things?\u00a0
\n2) Feeling down, depressed, or hopeless?
\n3) trouble falling or staying asleep, or sleeping too much? \u2028\u00a0\u00a0
\n4) Feeling tired or having little energy?\u2028
\n5) poor appetite or overeating?\u2028
\n6) feeling bad about yourself – or that you are a failure or have let yourself or your family down?
\n7) trouble concentrating on things, such as reading the newspaper or watching television?\u2028\u00a0
\n8) moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual?\u2028
\n9) thoughts that you would be better off dead, or of hurting yourself in some way?\u2028\u00a0
\nfor each of the nine tested criteria there are four possible answers: \u2028
\nNot at all = 0 points\u2028
\nSeveral days = 1 point
\nMore than half the days = 2 points
\nNearly every day = 3 points\u2028
\nthe maximum total score is 9×3 = 27 points and the patient’s score is thus a score out of 27 (e.g. 16 points = 16\/27)\u2028\u00a0\u00a0 \u00a0depression severity is graded based on the PHQ-9 score:
\n0-4 None\u2028\u00a0
\n5-9 mild\u2028\u00a0
\n10-14 moderate
\n15-19 moderately severe
\n20-27 severe\u2028\u3053\u306e\u7814\u7a76\u3067\u306f7\u70b9\u4ee5\u4e0a\u3092\u6291\u3046\u3064\u75c7\u72b6\u3042\u308a\u3068\u3057\u305f\u3002\u2028\u2028\u2028<\/p>\n
\u3010\u958b\u50ac\u65e5\u3011\u2028
\n2011\u5e749\u67088\u65e5<\/p>\n","protected":false},"excerpt":{"rendered":"