Whittemore Robin, Kanner Sheri, Singleton Sabrina, Hamrin Vanya, Chiu Joy, Grey Margaret
Yale School of Nursing, New Haven, CT 06535-0740, USA.
Pediatr Diabetes. 2002 Sep;3(3):135-43. doi: 10.1034/j.1399-5448.2002.30303.x.
To determine correlates of depression in adolescents with type 1 diabetes.
Data on 117 adolescents participating in a longitudinal study (72 F, 45 M; 95 W; age = 14.3 +/- 2.0 yr; duration = 6.3 +/- 3.7) were collected with the Children's Depression Inventory (CDI), Diabetes Family Behavior Scale (DFBS), Family Adaptability and Cohesion Scale (FACES), and chart review at study entry and 2-year follow-up.
Fifteen per cent of adolescents in this sample demonstrated depressive symptoms (CDI > 13) at study entry and 10% at 2 yr follow-up. Adolescents aged 14.1-16 yr and those with diabetes > 10 yr demonstrated the highest rates. When demographic/clinical variables were controlled, the DFBS warmth-caring subscale (p = 0.001) and the FACES adaptability subscale (p = 0.005), but not DFBS guidance-control (p = 0.635), contributed significantly to the explained variance in depressive symptoms (R(2) = 0.27) at study entry. At 2 yr follow-up, study entry CDI scores were the only significant predictor of depressive symptoms (R(2) = 0.40). By 2 yr, adolescents with depressive symptoms had significantly higher HbA1c than those without (p = 0.03).
The prevalence of depressive symptoms in adolescents with type 1 diabetes coupled with the potential impact of depressive symptoms on metabolic control suggest the need for early diagnosis and treatment. Greater attention to psychosocial outcomes of youth, family functioning, and the potential burden of diabetes over time to youth/families is indicated.
确定1型糖尿病青少年抑郁的相关因素。
采用儿童抑郁量表(CDI)、糖尿病家庭行为量表(DFBS)、家庭适应性和凝聚力量表(FACES),并在研究开始时和随访2年时查阅病历,收集了117名参与纵向研究的青少年的数据(72名女性,45名男性;95名白人;年龄 = 14.3±2.0岁;病程 = 6.3±3.7年)。
该样本中15%的青少年在研究开始时表现出抑郁症状(CDI>13),随访2年时为10%。年龄在14.1 - 16岁的青少年以及糖尿病病程>10年的青少年发病率最高。当控制人口统计学/临床变量时,DFBS的温暖关怀子量表(p = 0.001)和FACES的适应性子量表(p = 0.005),而不是DFBS的指导控制子量表(p = 0.635),对研究开始时抑郁症状的解释方差有显著贡献(R² = 0.27)。在随访2年时,研究开始时的CDI评分是抑郁症状的唯一显著预测因素(R² = 0.40)。到2年时,有抑郁症状的青少年的糖化血红蛋白水平显著高于无抑郁症状的青少年(p = 0.03)。
1型糖尿病青少年抑郁症状的患病率以及抑郁症状对代谢控制的潜在影响表明需要早期诊断和治疗。提示应更加关注青少年的心理社会结局、家庭功能以及糖尿病随时间对青少年/家庭的潜在负担。