Paschalides C, Wearden A J, Dunkerley R, Bundy C, Davies R, Dickens C M
Diabetes Research Group, Manchester Diabetes Centre, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
J Psychosom Res. 2004 Dec;57(6):557-64. doi: 10.1016/j.jpsychores.2004.03.006.
This study examined the interrelationships of anxiety, depression and personal illness representations with glycaemic control and health-related quality of life in adults with Type 2 diabetes.
One hundred eighty-four consecutive patients with Type 2 diabetes mellitus completed the Illness Perception Questionnaire (IPQ), the Well-Being Scale (WBQ) and the Short Form 36 Health Survey Questionnaire (SF-36). Demographic characteristics, details of diabetes status (duration of diabetes, treatments and complications) and glycosylated haemoglobin (HbA1c) were recorded.
Depression was correlated with greater perceived symptom load (r = .48, P < .01), worse anticipated consequences (r = -.41, P < .01) and perceived lack of control of diabetes (r = .28, P < .01). After controlling for demographic and illness characteristics, personal illness representations relating to symptom load and anticipated consequences were independently associated with the SF-36 physical functioning score, contributing an additional 15% to the variance. WBQ depression and anxiety scores, along with IPQ control and consequences, were independently associated with SF-36 mental function score, contributing a further 51% to the variance after controlling for demographic and illness details. Neither IPQ nor WBQ scales were associated with HbA1c after controlling for demographic and medical illness details.
Anxiety, depression and negative beliefs about illness influence physical and mental functioning, but not metabolic control in patients with diabetes.
本研究探讨了2型糖尿病成年患者焦虑、抑郁及个人疾病认知与血糖控制及健康相关生活质量之间的相互关系。
184例连续的2型糖尿病患者完成了疾病认知问卷（IPQ）、幸福感量表（WBQ）和健康调查简表36（SF-36）。记录了人口统计学特征、糖尿病状况详情（糖尿病病程、治疗及并发症）和糖化血红蛋白（HbA1c）。
抑郁与更高的感知症状负荷相关（r = 0.48，P < 0.01）、更差的预期后果相关（r = -0.41，P < 0.01）以及糖尿病感知控制不足相关（r = 0.28，P < 0.01）。在控制了人口统计学和疾病特征后，与症状负荷和预期后果相关的个人疾病认知与SF-36身体功能评分独立相关，对变异的贡献率额外增加了15%。WBQ抑郁和焦虑评分，以及IPQ控制和后果评分，与SF-36心理功能评分独立相关，在控制了人口统计学和疾病详情后，对变异的贡献率进一步增加了51%。在控制了人口统计学和疾病详情后，IPQ和WBQ量表均与HbA1c无关。
焦虑、抑郁和对疾病的负面信念影响糖尿病患者的身体和心理功能，但不影响代谢控制。
