在基层医疗保健环境中，2 型糖尿病老年患者中抑郁障碍的患病率及其相关因素。
Prevalence and correlates of depressive disorders in elderly with type 2 diabetes in primary health care settings.
机构信息
Ain Shams University, Egypt.
出版信息
J Affect Disord. 2010 Jun;123(1-3):197-201. doi: 10.1016/j.jad.2009.09.002. Epub 2009 Oct 4.
OBJECTIVE
Depression is associated with poor glycemic control and complications in people with type 2 diabetes. We assessed the prevalence of depressive symptoms and antidepressant medication use among elderly with and without type 2 diabetes and the association between depression and diabetes complications.
RESEARCH DESIGN AND METHODS
In 2004-2006, the Primary Health Care research in Type 2 Diabetes Study applied the Beck Depression Inventory II (BDI-II) to 458 participants with type 2 diabetes (47% male, aged 65 + or -8.9 years, type 2 diabetes duration 19 + or - 8.7 years) and 546 participants without diabetes (non diabetic group) (51% male, aged 59 + or - 8.7 years). Use of antidepressant medication was self-reported. Depressive disorder was defined as a BDI-II score >14 and/or use of antidepressant medication. Occurrence of diabetes complications (retinopathy, blindness, neuropathy, diabetes-related amputation, and kidney or pancreas transplantation) was self-reported.
RESULTS
Mean BDI-II score, adjusted for age and sex, was significantly higher in participants with type 2 diabetes than in non diabetic participants (least-squares mean + or - SE: 7.4 + or - 0.3 vs. 5.0 + or - 0.3; P<0.0001). The prevalence of depressive disorder (as defined by BDI-II>14 and/or antidepressant use) in participants with type 2 diabetes was significantly higher than that of age- and sex-adjusted non diabetic participants (32.1 vs. 16.0%, P<0.0001). Type 2 diabetic participants reported using more antidepressant medications (20.7 vs. 12.1%, P = 0.0003). More type 2 diabetic than non diabetic participants were classified as depressed by BDI-II cut score (17.5 vs. 5.7%, P<0.0001) or by either BDI-II cut score or antidepressant use (32.1 vs. 16.0%, P<0.0001). Participants reporting diabetes complications (n = 209) had higher mean BDI-II scores than those without complications (10.7 + or - 9.3 vs. 6.4 + or - 6.3, P<0.0001).
CONCLUSIONS
Depression is highly prevalent in type 2 diabetes and requires further study on assessment and treatment.
目的
抑郁与 2 型糖尿病患者血糖控制不良和并发症有关。我们评估了患有和不患有 2 型糖尿病的老年人中抑郁症状的患病率和抗抑郁药物的使用情况，以及抑郁与糖尿病并发症之间的关系。
研究设计和方法
在 2004-2006 年，2 型糖尿病的初级保健研究应用贝克抑郁量表第二版（BDI-II）对 458 名患有 2 型糖尿病的参与者（47%为男性，年龄 65+/-8.9 岁，2 型糖尿病病程 19+/-8.7 年）和 546 名无糖尿病的参与者（非糖尿病组）（51%为男性，年龄 59+/-8.7 岁）进行了评估。抗抑郁药物的使用情况为自我报告。抑郁障碍的定义为 BDI-II 评分>14 分和/或使用抗抑郁药物。糖尿病并发症（视网膜病变、失明、神经病变、糖尿病相关截肢和肾脏或胰腺移植）的发生情况为自我报告。
结果
调整年龄和性别后，2 型糖尿病患者的 BDI-II 评分均值（最小二乘法均值+/-标准误）明显高于非糖尿病患者（7.4+/-0.3 对 5.0+/-0.3；P<0.0001）。2 型糖尿病患者的抑郁障碍患病率（根据 BDI-II>14 分和/或使用抗抑郁药物定义）明显高于年龄和性别调整后的非糖尿病患者（32.1%对 16.0%，P<0.0001）。2 型糖尿病患者报告使用更多的抗抑郁药物（20.7%对 12.1%，P=0.0003）。与 BDI-II 截断值（17.5%对 5.7%，P<0.0001）或 BDI-II 截断值和抗抑郁药物使用（32.1%对 16.0%，P<0.0001）相结合，更多的 2 型糖尿病患者被归类为抑郁。报告患有糖尿病并发症（n=209）的患者的 BDI-II 评分均值高于无并发症的患者（10.7+/-9.3 对 6.4+/-6.3，P<0.0001）。
结论
抑郁在 2 型糖尿病中非常普遍，需要进一步研究评估和治疗。
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