Lloyd C E, Dyer P H, Barnett A H
School of Health & Social Welfare, The Open University, Milton Keynes, UK.
Diabet Med. 2000 Mar;17(3):198-202. doi: 10.1046/j.1464-5491.2000.00260.x.
To investigate the use of a short questionnaire to measure psychological symptoms in a busy clinic setting, and to examine the prevalence of these symptoms in adults with diabetes. The perceived need for psychological treatment services was also measured.
Adults (> 18 years) with either Type 1 or Type 2 diabetes were invited to complete a short demographic form and the Hospital Anxiety and Depression Scale (HADS) whilst waiting for their routine diabetes outpatients appointment. Complication status was measured via patients' medical records. Glycaemic control (HbA(1c)) was also recorded.
A high response rate (96%) was achieved. Prevalence rates of psychological symptoms were high (overall 28% of study participants reported moderate-severe levels of depression or anxiety or both). Men were somewhat more likely to report moderate-severe depressive symptoms, whereas women reported more moderate-severe anxiety. A significant association between depression and poor glycaemic control was observed in the men, but not in the women. Regression analysis demonstrated that the interaction between sex and glycaemic control, HbA(1c) and sex were all significantly associated with depression and anxiety (R2 = 0.16 and 0.19, respectively). One-third of subjects reported that at the moment they would be interested in receiving counselling or psychotherapy if it was currently available at the diabetes clinic.
This study has shown that the HADS is an appropriate questionnaire to use in a clinic setting in adults with diabetes. There may be a stronger association between glycaemic control and psychological symptomatology in men than in women. There remains a significant proportion of individuals with diabetes who require psychological support, which, if available, might help improve glycaemic control and thus overall wellbeing.
研究在繁忙的诊所环境中使用简短问卷来测量心理症状,并调查这些症状在成年糖尿病患者中的患病率。同时还测量了对心理治疗服务的感知需求。
邀请1型或2型糖尿病成年患者(年龄>18岁)在等待常规糖尿病门诊预约时填写简短的人口统计学表格和医院焦虑抑郁量表(HADS)。通过患者病历测量并发症状态。还记录了血糖控制情况(糖化血红蛋白[HbA₁c])。
获得了较高的应答率(96%)。心理症状的患病率较高(总体上,28%的研究参与者报告有中度至重度抑郁或焦虑或两者兼有)。男性报告中度至重度抑郁症状的可能性略高,而女性报告更多中度至重度焦虑症状。在男性中观察到抑郁与血糖控制不佳之间存在显著关联,但在女性中未观察到。回归分析表明,性别与血糖控制、HbA₁c与性别的相互作用均与抑郁和焦虑显著相关(R²分别为0.16和0.19)。三分之一的受试者报告称,如果糖尿病诊所目前提供咨询或心理治疗,他们目前会有兴趣接受。
本研究表明,HADS是适用于成年糖尿病患者诊所环境的问卷。男性中血糖控制与心理症状之间的关联可能比女性更强。仍有相当比例的糖尿病患者需要心理支持,如果能获得这种支持,可能有助于改善血糖控制,从而提高整体健康水平。