Ascher-Svanum Haya, Zhu Baojin, Ernst Frank R, Faries Douglas E, Jacobson Jennie G, Doebbeling Caroline C
Eli Lilly and Co., Outcomes Research.
Prim Care Companion J Clin Psychiatry. 2007;9(2):122-8. doi: 10.4088/pcc.v09n0206.
This prospective observational study compared the 3-year clinical and functional course of schizophrenia among individuals with and without diabetes at study entry.
Data were drawn from a large, 3-year, multisite, prospective, naturalistic study of treatment for schizophrenia-related disorders. The study was conducted in the United States between July 1997 and September 2003 and represented treatment practices in diverse systems of care. Participants were diagnosed with schizophrenia or schizoaffective or schizophreniform disorders based on DSM-IV criteria. Clinical and functional outcomes were assessed at study enrollment and at 12-month intervals using standard psychiatric measures, medical records, and a validated patient-reported questionnaire. Diabetes status was determined by participant interview at enrollment. Statistical analyses used mixed models with repeated measures.
Of 594 participants queried about comorbid medical conditions at enrollment, 76 (12.8%) reported having diabetes. Other comor-bid conditions were reported by 79% of the diabetes group (N = 60) and 50% of the nondiabetes group (N = 259). Across the 3-year study, participants with diabetes differed significantly from participants without diabetes on 2 of 36 outcome measures: more contacts with nonpsychiatrist physicians (p < .001) and poorer physical health (p = .015). Groups did not differ significantly on mental health symptomatology, mental health resource utilization, legal and safety issues, substance use, productivity, activities and relationships, or quality of life.
In this 3-year, prospective, naturalistic study, the course of schizophrenia did not differ significantly between participants with and without diabetes, although persons with diabetes did have poorer physical health and more contacts with nonpsychiatrist physicians. Findings highlight the need for better medical treatment for people with schizophrenia, both with and without comorbid diabetes.
这项前瞻性观察性研究比较了入组时患有和未患有糖尿病的精神分裂症患者3年的临床及功能病程。
数据来自一项针对精神分裂症相关障碍治疗的大型、为期3年、多中心、前瞻性、自然主义研究。该研究于1997年7月至2003年9月在美国进行，代表了不同医疗体系中的治疗实践。参与者根据《精神疾病诊断与统计手册》第四版标准被诊断为精神分裂症、分裂情感性障碍或精神分裂症样障碍。在研究入组时及之后每隔12个月，使用标准的精神科测量方法、病历记录以及一份经过验证的患者报告问卷对临床和功能结局进行评估。糖尿病状态通过入组时参与者访谈确定。统计分析采用重复测量的混合模型。
在入组时被询问共病医疗状况的594名参与者中，76人（12.8%）报告患有糖尿病。糖尿病组（N = 60）的79%和非糖尿病组（N = 259）的50%报告有其他共病状况。在为期3年的研究中，糖尿病患者与非糖尿病患者在36项结局指标中的2项上存在显著差异：与非精神科医生的接触更多（p < .001），身体健康状况更差（p = .015）。两组在心理健康症状、心理健康资源利用、法律和安全问题、物质使用、生产力、活动和人际关系或生活质量方面没有显著差异。
在这项为期3年的前瞻性自然主义研究中，患有和未患有糖尿病的精神分裂症患者病程没有显著差异，尽管糖尿病患者身体健康状况较差且与非精神科医生的接触更多。研究结果凸显了对患有和未患有糖尿病共病的精神分裂症患者进行更好医疗治疗的必要性。
