Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T
Research Institute of the Diabetes Academy, Diabetes Centre Mergentheim, Germany.
Diabet Med. 2005 Mar;22(3):293-300. doi: 10.1111/j.1464-5491.2005.01414.x.
The aims of this study were to examine (1) the prevalence of clinical and subclinical anxiety and affective disorders in a sample of diabetic patients attending a secondary care clinic in Germany and (2) risk factors associated with the occurrence of these disorders.
Four hundred and twenty diabetic patients (36.9% Type 1; 24.7% Type 2; 38.4% Type 2 with insulin) participated in a questionnaire-based screening survey. Those who screened positive received a diagnostic interview.
Prevalence of clinical affective disorders was 12.6%, with an additional 18.8% of patients reporting depressive symptoms without fulfilling all criteria for a clinical affective disorder. The prevalence of anxiety disorders was 5.9%, with an additional 19.3% of patients reporting some anxiety symptoms. The comorbidity rate of affective and anxiety disorders was 1.8%, whereas 21.4% of the diabetic patients reported elevated affective as well as anxiety symptomatology. Logistic regression established demographic variables such as age, female gender and living alone as well as diabetes-specific parameters such as insulin treatment in Type 2 diabetes, hypoglycaemia problems and poor glycaemic control as risk factors for affective disorders. For anxiety symptoms female gender, younger age and Type 2 diabetes were significant independent variables.
The prevalence of affective disorders in diabetic patients was twofold higher than in the non-diabetic population, whereas prevalence for anxiety disorders was not increased. Analysis of risk factors can facilitate the identification of patients who are at a greater risk for these disorders.
本研究的目的是调查（1）在德国一家二级护理诊所就诊的糖尿病患者样本中临床和亚临床焦虑及情感障碍的患病率，以及（2）与这些障碍发生相关的危险因素。
420名糖尿病患者（1型糖尿病占36.9%；2型糖尿病占24.7%；2型糖尿病使用胰岛素治疗的占38.4%）参与了一项基于问卷的筛查调查。筛查呈阳性的患者接受诊断访谈。
临床情感障碍的患病率为12.6%，另有18.8%的患者报告有抑郁症状，但未满足临床情感障碍的所有标准。焦虑障碍的患病率为5.9%，另有19.3%的患者报告有一些焦虑症状。情感障碍和焦虑障碍的共病率为1.8%，而21.4%的糖尿病患者报告情感症状和焦虑症状均有所增加。逻辑回归确定了年龄、女性性别和独居等人口统计学变量，以及2型糖尿病中的胰岛素治疗、低血糖问题和血糖控制不佳等糖尿病特异性参数为情感障碍的危险因素。对于焦虑症状，女性性别、较年轻的年龄和2型糖尿病是显著的独立变量。
糖尿病患者中情感障碍的患病率是非糖尿病人群的两倍，而焦虑障碍的患病率没有增加。对危险因素的分析有助于识别这些障碍风险较高的患者。
