Moreira R O, Papelbaum M, Fontenelle L F, Appolinario J C, Ellinger V C M, Coutinho W F, Zagury L
Unidade de Psiconeuroendocrinologia, Instituto Estadual de Diabetes e Endocrinologia/Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rua Moncorvo Filho 90, 20211-340 Rio de Janeiro, RJ, Brazil.
Braz J Med Biol Res. 2007 Feb;40(2):269-75. doi: 10.1590/s0100-879x2007000200015.
The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8%). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 +/- 1.97 vs 7.48 +/- 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0%; P = 0.01), and major depression--current episode, in particular (18.2 vs 7.7%; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.
本研究的目的是确定患有对称性远端多发性神经病变（SDPN）的糖尿病患者样本中精神疾病共病的发生率。连续选取65例2型糖尿病患者参与圣保罗州糖尿病与内分泌研究所的这项研究。所有患者均接受了全面的临床和精神评估，包括葡萄牙语版的DSM-IV结构化临床访谈、贝克抑郁量表、神经病变症状评分和神经病变残疾评分。22名受试者（33.8%）被确诊为SDPN。有无SDPN的患者在社会人口学特征方面无显著差异。然而，与无SDPN的患者相比，SDPN患者的血糖控制有变差的趋势（糖化血红蛋白=8.43±1.97 vs 7.48±1.95；P=0.08）。SDPN患者出现轴I精神障碍的频率显著高于无SDPN的患者（总体上尤其是焦虑症，81.8% vs 60.0%；P=0.01），特别是当前发作的重度抑郁症（18.2% vs 7.7%；P=0.04）。抑郁症状的严重程度与SDPN症状的严重程度呈正相关（r=0.38；P=0.006），但与SDPN体征的严重程度无关（r=0.07；P=0.56）。总之，SDPN的存在似乎与血糖控制变差的趋势有关。糖尿病患者中SDPN的诊断似乎也与包括焦虑和当前情绪障碍在内的相关精神疾病共病有关。
