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2型糖尿病患者中不同程度共病抑郁的严重糖尿病特异性情绪问题:欧洲糖尿病抑郁(EDID)研究联盟的一项波兰研究

Serious diabetes-specific emotional problems in patients with type 2 diabetes who have different levels of comorbid depression: a Polish study from the European Depression in Diabetes (EDID) Research Consortium.

作者信息

Kokoszka A, Pouwer F, Jodko A, Radzio R, Mućko P, Bieńkowska J, Kuligowska E, Smoczyńska O, Skłodowska Z

机构信息

Department of Psychiatry II, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland.

出版信息

Eur Psychiatry. 2009 Oct;24(7):425-30. doi: 10.1016/j.eurpsy.2009.04.002. Epub 2009 Jun 21.

Abstract

OBJECTIVE

Depression is a common psychiatric problem in patients with type 2 diabetes (DM2). A common view is that the burden of having DM2 contributes to the development of depression in DM2. Aim of the present study was to compare the levels of diabetes-specific emotional problems of DM2 patients with diagnosed depression with those with a subclinical form of depression and those without depression.

METHODS

A cross-sectional study was conducted in 101 DM2 patients (51 men and 50 women, mean age = 63,17; SD = 10,74) who completed a standardized, structured psychiatric diagnostic interview (MINI), the Beck Depression Inventory, the Hamilton Depression Rating Scale as well as the Problem Areas in Diabetes (PAID) scale (a 20-item measure, with an overall scale measuring diabetes-related emotional distress and four subscales [negative emotions, treatment-related problems, food-related problems, lack of social support]).

RESULTS

A depression diagnosis was made in 35% (n = 35) of the participants, 24% (n = 24) had a subclinical form of depression, 42% (n = 42) were not diagnosed with any kind of depressive disorder. Diabetes-specific emotional problems were most common in DM2 patients with a depressive disorder (significantly highest PAID score: 39) compared to patients with subclinical depression or no depression. In the group of non-depressed patients, only 14% agreed to have four or more (somewhat) serious diabetes-specific problems. In those with subclinical depression, this percentage was 42% and in those with a depressive disorder 49% (P < 0.001).

CONCLUSIONS

Diabetes-related emotional problems are particularly common among DM2 patients with comorbid clinical depression and to a lesser extent in patients with subclinical depression, compared to non-depressed DM2 patients. Male diabetes patients with a depressive disorder are particularly vulnerable to develop high levels of diabetes-specific emotional distress. Major differences between the three groups mainly concern the diabetes-specific problems connected with the illness.

摘要

目的

抑郁症是2型糖尿病(DM2)患者中常见的精神问题。一种普遍观点认为,患DM2的负担会促使DM2患者发生抑郁症。本研究的目的是比较已确诊抑郁症的DM2患者、亚临床抑郁症形式的患者以及无抑郁症患者的糖尿病特异性情绪问题水平。

方法

对101例DM2患者(51例男性和50例女性,平均年龄 = 63.17;标准差 = 10.74)进行了一项横断面研究,这些患者完成了标准化的结构化精神科诊断访谈(MINI)、贝克抑郁量表、汉密尔顿抑郁评定量表以及糖尿病问题领域(PAID)量表(一项包含20个条目的测量工具,其整体量表测量与糖尿病相关的情绪困扰以及四个子量表[负面情绪、治疗相关问题、饮食相关问题、缺乏社会支持])。

结果

35%(n = 35)的参与者被诊断为抑郁症,24%(n = 24)有亚临床抑郁症形式,42%(n = 42)未被诊断出患有任何类型的抑郁症。与亚临床抑郁症患者或无抑郁症患者相比,糖尿病特异性情绪问题在患有抑郁症的DM2患者中最为常见(PAID得分显著最高:39)。在无抑郁症患者组中,只有14%的人同意有四个或更多(某种程度上)严重的糖尿病特异性问题。在亚临床抑郁症患者中,这一比例为42%,在抑郁症患者中为49%(P < 0.001)。

结论

与未患抑郁症的DM2患者相比,糖尿病相关情绪问题在合并临床抑郁症的DM2患者中尤为常见,在亚临床抑郁症患者中程度较轻。患有抑郁症的男性糖尿病患者特别容易出现高水平的糖尿病特异性情绪困扰。三组之间的主要差异主要涉及与疾病相关的糖尿病特异性问题。

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