2型糖尿病患者抑郁症的相关危险因素。

Risk factors associated with depression in patients with type 2 diabetes mellitus.

作者信息

Téllez-Zenteno José Francisco, Cardiel Mario H

机构信息

Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico.

出版信息

Arch Med Res. 2002 Jan-Feb;33(1):53-60. doi: 10.1016/s0188-4409(01)00349-6.

DOI:10.1016/s0188-4409(01)00349-6

PMID:11825632

Abstract

BACKGROUND

This study was undertaken in order to identify the prevalence and factors associated with depression in a group of patients with type 2 diabetes mellitus.

METHODS

Our design consisted of a cross-sectional study at the Department of Neurology and Psychiatry of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City. Study units included 189 patients with type 2 diabetes mellitus (DM). Beck Depression Inventory scale was used to measure the presence of depression, while the independent variables evaluated to explain depression were sociodemographic (gender, marital status, religion, education, occupation, socioeconomic status) and characteristics of the disease were disease duration, comorbidity, compliance, and glycemic control.

RESULTS

Prevalence of depression was 39% (74 patients). The following risk factors were identified by univariate analysis: being widowed (OR 3.54, confidence interval [CI] 1.56-8.11, p = 0.0007); female (OR 2.95, CI 1.50-5.82, p = 0.006); housewife (OR 2.08, CI 1.10-3.94, p = 0.01); poor compliance (OR 2.14, CI 1.12-4.10, p = 0.01), and presence of comorbidity (OR 5.60, CI 1.51-24.5, p = 0.002). On the other hand, the most constant associations were presence of blood glucose at the last appointment >or=200 (OR 3.23, CI 1.59-6.60, p = 0.0003) and >or=250 (OR 2.15, CI 0.93-5.03, p = 0.05), as the average of the last five blood glucoses >or=200 (OR 3.67, CI 1.76-7.73, p = 0.0001), >or=250 (OR 4.07, CI 1.61-10.49, p = 0.0007) and >or=300 (OR 2.12, CI 1.48-3.02, p = 0.003). Discriminant function analysis of the variables, previously studied in univariate analysis, was carried out for the presence of depression. A stepwise model included the following variables: average of the last five blood glucoses; 2) widowed or divorced, and 3) female.

CONCLUSIONS

Frequency of depression in patients with type 2 DM was high (39%). High level of blood glucose stands out as a variable associated with presence of depression. Other associations were presence of comorbidity, being a female, and being widowed or divorced.

摘要

背景

开展本研究以确定一组2型糖尿病患者中抑郁症的患病率及相关因素。

方法

我们的研究设计为在墨西哥城萨尔瓦多·苏比拉án国家医学与营养科学研究所神经病学和精神病学系进行的一项横断面研究。研究对象包括189例2型糖尿病（DM）患者。采用贝克抑郁量表来测量抑郁症的存在情况，而用于解释抑郁症的自变量为社会人口统计学因素（性别、婚姻状况、宗教信仰、教育程度、职业、社会经济地位）以及疾病特征，如病程、合并症、依从性和血糖控制情况。

结果

抑郁症患病率为39%（74例患者）。单因素分析确定了以下危险因素：丧偶（比值比[OR] 3.54，置信区间[CI] 1.56 - 8.11，p = 0.0007）；女性（OR 2.95，CI 1.50 - 5.82，p = 0.006）；家庭主妇（OR 2.08，CI 1.10 - 3.94，p = 0.01）；依从性差（OR 2.14，CI 1.12 - 4.10，p = 0.01），以及存在合并症（OR 5.60，CI 1.51 - 24.5，p = 0.002）。另一方面，最稳定的关联因素为上次就诊时血糖≥200（OR 3.23，CI 1.59 - 6.60，p = 0.0003）和≥250（OR 2.15，CI 0.93 - 5.03，p = 0.05），以及最近五次血糖平均值≥200（OR 3.67，CI 1.76 - 7.73，p = 0.0001）、≥250（OR 4.07，CI 1.61 - 10.49，p = 0.0007）和≥300（OR 2.12，CI 1.48 - 3.02，p = 0.003）。针对抑郁症的存在情况，对先前在单因素分析中研究过的变量进行判别函数分析。逐步模型纳入了以下变量：1）最近五次血糖平均值；2）丧偶或离异；3）女性。