抑郁和糖尿病：与五年随访时重度抑郁相关的因素。
Depression and diabetes: factors associated with major depression at five-year follow-up.
机构信息
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA.
出版信息
Psychosomatics. 2009 Nov-Dec;50(6):570-9. doi: 10.1176/appi.psy.50.6.570.
BACKGROUND
In patients with diabetes, comorbid depression has been shown to be associated with increased medical symptom burden, additional functional impairment, poor self-care, increased risk of macrovascular and microvascular complications, higher medical costs, and greater mortality.
OBJECTIVE
The authors performed a longitudinal observation to assess the pathway between diabetes complications and subsequent depression.
METHOD
In a prospective study of primary-care patients with diabetes (N=2,759), the authors determined, from automated data and chart review, whether macrovascular or microvascular events or coronary, cerebrovascular, or peripheral vascular procedures during follow-up were associated with meeting criteria for major depression at 5-year follow-up.
RESULTS
After controlling for baseline severity of depression symptoms and history of depression, having one-or-more coronary procedures during follow-up, and baseline severity of diabetes symptoms were strong predictors of having major depression at 5-year follow-up.
CONCLUSION
The risk of major depression among persons with diabetes is increased by previous depression history, baseline diabetes symptoms, and having had cardiovascular procedures.
背景
在糖尿病患者中，合并抑郁与更高的医疗症状负担、更多的功能损伤、较差的自我护理、更大的大血管和微血管并发症风险、更高的医疗费用以及更高的死亡率相关。
目的
作者进行了一项纵向观察，以评估糖尿病并发症与随后发生抑郁之间的关系。
方法
在一项针对初级保健患者的糖尿病前瞻性研究（N=2759）中，作者通过自动数据和图表审查，确定在随访期间是否发生大血管或微血管事件，或是否进行了冠状动脉、脑血管或外周血管手术，与在 5 年随访时符合重度抑郁标准相关。
结果
在控制了基线抑郁症状严重程度和抑郁病史、随访期间进行过一次或多次冠状动脉手术以及基线糖尿病症状严重程度后，随访期间进行过一次或多次冠状动脉手术是 5 年后发生重度抑郁的强烈预测因素。
结论
有过抑郁病史、基线糖尿病症状以及接受过心血管手术的糖尿病患者，发生重度抑郁的风险更高。
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