Eren Ibrahim, Erdi Ozlem, Ozcankaya Ramazan
Turk Psikiyatri Derg. 2003 Fall;14(3):184-91.
To explore specific psychiatric comorbidity among type II DM patients with poor and good glycemic control.
One hundred four patients with type II DM attending outpatient department of the Endocrinology Unit of Süleyman Demirel University Medical Faculty were included in this study. Patients were divided into two groups according to HbA1c level: >7% defined group 1 with poor glycemic control (n=40), and <7% defined group 2 with good glycemic control (n=64). All patients were assessed using a semi structured sociodemographic data form, the Structured Clinical Interview for DSM-IV-Clinical Version (SCID-I/CV), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and the Minimental State Examination Scale.
The prevalence rate of psychiatric disorders were as follows: major depressive disorder 67.5%, dysthymic disorder 10.0%, generalized anxiety disorder 7.5%, obsessive compulsive disorder 5%, social phobia 2.5% and nicotine dependence 5% in group 1 patients; and major depressive disorder 43.8%, dysthymic disorder 10.9%, paranoid disorder 3.1%, obsessive compulsive disorder 6.3%, social phobia 4.7%, generalized anxiety disorder 6.3%, nicotine dependence 9.4% and alcohol dependence 3.1% in group 2 patients. Major depressive disorder frequency was significantly higher in group1 patients than group 2 patients. HDRS and HARS scores were significantly higher in group 1 patients than in group 2 patients. Significant positive correlations were found between HDRS, HARS scores, number of depressive episodes and the level of HbA1c in the diabetic patients.
Major depressive disorder was more frequent in diabetic patients with poor glycemic control than in those with good glycemic control. There was a strong association between level of HbA1c and depression and anxiety symptom level.
探讨血糖控制不佳和良好的2型糖尿病患者中特定的精神共病情况。
本研究纳入了104例就诊于苏莱曼·德米雷尔大学医学院内分泌科门诊的2型糖尿病患者。根据糖化血红蛋白（HbA1c）水平将患者分为两组：HbA1c>7%定义为血糖控制不佳的第1组（n=40），HbA1c<7%定义为血糖控制良好的第2组（n=64）。所有患者均使用半结构化社会人口学数据表、《精神疾病诊断与统计手册》第四版临床版结构化临床访谈（SCID-I/CV）、汉密尔顿抑郁量表（HDRS）、汉密尔顿焦虑量表（HARS）和简易精神状态检查表进行评估。
第1组患者精神障碍的患病率如下：重度抑郁症67.5%，心境恶劣障碍10.0%，广泛性焦虑障碍7.5%，强迫症5%，社交恐惧症2.5%，尼古丁依赖5%；第2组患者中，重度抑郁症43.8%，心境恶劣障碍10.9%，偏执性障碍3.1%，强迫症6.3%，社交恐惧症4.7%，广泛性焦虑障碍6.3%，尼古丁依赖9.4%，酒精依赖3.1%。第1组患者中重度抑郁症的发生率显著高于第2组患者。第1组患者的HDRS和HARS评分显著高于第2组患者。糖尿病患者的HDRS、HARS评分、抑郁发作次数与HbA1c水平之间存在显著正相关。
血糖控制不佳的糖尿病患者中重度抑郁症的发生率高于血糖控制良好的患者。HbA1c水平与抑郁和焦虑症状水平之间存在密切关联。
