Schmitz Norbert, Wang JianLi, Lesage Alain, Malla Ashok, Strychar Irene
Department of Psychiatry, McGill University, Douglas Hospital Research Center, Montreal, Quebec, Canada.
J Psychosom Res. 2008 Aug;65(2):165-72. doi: 10.1016/j.jpsychores.2008.03.004. Epub 2008 May 27.
Psychological distress may have different effects on short-term disability depending on individual disease severity, which can affect daily life activities. The objective of this study was to evaluate the interaction between psychological distress and activity limitations in daily life, in relation to self-reported disability days in a community sample of people with diabetes.
The responses of 3082 adults with self-reported diabetes to the Canadian Community Health Survey Cycle 3.1 were analyzed.
Prevalence of disability days was higher in diabetic subjects with coexisting psychological distress and activity limitations (67%) than in individuals with either activity limitations in daily life (38%) or psychological distress (30%) alone. With no psychological distress and no activity limitations as reference and after adjusting for relevant covariates, the odds ratio of disability was 2.63 [95% confidence interval (95% CI)=1.60-4.33] for psychological distress, 5.57 (95% CI=3.86-8.05) for activity limitations, and 19.4 (95% CI=11.7-31.9) for activity limitations and comorbid psychological distress.
The results suggest that there is a joint effect of psychological distress and activity limitations on short-term disability. Detecting and managing psychological distress might be particularly beneficial for persons with diabetes.
心理困扰对短期残疾可能有不同影响，这取决于个体疾病严重程度，而疾病严重程度会影响日常生活活动。本研究的目的是评估心理困扰与日常生活活动受限之间的相互作用，以及在糖尿病患者社区样本中自我报告的残疾天数之间的关系。
分析了3082名自我报告患有糖尿病的成年人对加拿大社区健康调查第3.1轮的回答。
同时存在心理困扰和活动受限的糖尿病患者的残疾天数患病率（67%）高于仅存在日常生活活动受限（38%）或心理困扰（30%）的个体。以无心理困扰且无活动受限为参照，并在调整相关协变量后，心理困扰导致残疾的比值比为2.63 [95%置信区间（95%CI）=1.60 - 4.33]，活动受限导致残疾的比值比为5.57（95%CI = 3.86 - 8.05），活动受限合并心理困扰导致残疾的比值比为19.4（95%CI = 11.7 - 31.9）。
结果表明，心理困扰和活动受限对短期残疾存在联合效应。对糖尿病患者而言，检测和管理心理困扰可能特别有益。
