Simson Udo, Nawarotzky Ute, Porck Werner, Friese Gerd, Schottenfeld-Naor Yolanda, Hahn Sebastian, Scherbaum Werner A, Kruse Johannes
Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf.
Psychother Psychosom Med Psychol. 2008 Feb;58(2):44-50. doi: 10.1055/s-2007-971001. Epub 2007 Sep 10.
Compared to the population as a whole patients with diabetes mellitus suffer from a significantly higher rate of depressive symptoms, especially when they develop complications. Little is known about psychological strain in patients suffering from diabetic late complications such as the diabetic foot syndrome. In Germany the diabetic foot syndrome causes about 22,000 amputations every year. The present study examines depressive symptoms, anxiety, quality of life, diabetes-related problems and type D pattern in inpatients suffering from diabetic foot syndrome, describes associations with severity of somatic symptoms, and investigates the development of psychological strain in the course of the treatment.
111 inpatients with diabetic foot syndrome were given a set of questionnaires at the beginning and end of treatment. These recorded socio-demographic variables, anxiety and depression (HADS), quality of life (SF-12), diabetes-related problems (PAID) and type D pattern (DS14). 78 (70.3%) patients completed the set of questionnaires at both points of time.
At the beginning of the treatment 18% of the inpatients suffered from severe depressive symptoms, and 16.2 % suffered from moderate depressive symptoms. 16.4% of the patients suffered from severe anxiety, and 24.7% suffered from moderate anxiety (HADS). The prevalence rate of the type D pattern was 33.0%. The extent of anxiety and depression was not, as had been anticipated, associated with the severity of the physical symptoms. Although the diabetic foot syndrome improved significantly in most of the patients, the extent of depressive symptoms, anxiety and diabetes-related problems remained almost the same.
与普通人群相比,糖尿病患者出现抑郁症状的几率显著更高,尤其是在出现并发症时。对于患有糖尿病晚期并发症(如糖尿病足综合征)的患者的心理压力,我们了解甚少。在德国,糖尿病足综合征每年导致约22,000例截肢。本研究调查了患有糖尿病足综合征的住院患者的抑郁症状、焦虑、生活质量、糖尿病相关问题和D型模式,描述了与躯体症状严重程度的关联,并研究了治疗过程中心理压力的变化。
111例患有糖尿病足综合征的住院患者在治疗开始和结束时接受了一组问卷调查。这些问卷记录了社会人口统计学变量、焦虑和抑郁(医院焦虑抑郁量表)、生活质量(简明健康调查量表)、糖尿病相关问题(糖尿病患者特异性生活质量量表)和D型模式(DS14)。78名(70.3%)患者在两个时间点都完成了这组问卷。
治疗开始时,18%的住院患者患有严重抑郁症状,16.2%患有中度抑郁症状。16.4%的患者患有严重焦虑,24.7%患有中度焦虑(医院焦虑抑郁量表)。D型模式的患病率为33.0%。焦虑和抑郁的程度与预期相反, 与身体症状的严重程度无关。尽管大多数患者的糖尿病足综合征有显著改善,但抑郁症状、焦虑和糖尿病相关问题的程度几乎保持不变。