Zihl Josef, Schaaf Ludwig, Zillmer Eric A
Max Planck Institute of Psychiatry, 80404Munich, Germany.
Appl Neuropsychol. 2010 Jan;17(1):44-51. doi: 10.1080/09084280903526133.
The purpose of this study was to assess, in relation to metabolic control, the cognitive, depressive, and anxiety symptoms among 40 adult patients (age: 18-60 years) with either type 1 (n = 28) or type 2 (n = 12) diabetes mellitus (DM1, DM2). Nineteen healthy subjects matched for age, gender, and education served as the control group. For most cognitive domains, no significant performance differences were found between subjects from the diabetic groups and control subjects. However, diabetes patients demonstrated reduced information processing accuracy along with impaired visual and verbal working memory performance. In addition, psychopathology scores were significantly elevated but did not reach the clinical criteria for depression or anxiety. Overall, there were no significant differences between diabetic subgroups, and no significant correlation was found between cognitive performance, psychopathology scores, and HbA1c values for either subgroup. Thus, patients with DM1 or DM2 may show mild-to-moderate cognitive impairment as well as subtle psychopathological symptoms. While cognitive impairments may be understood in terms of diabetes-associated cognitive dysfunction, psychopathological symptoms may also result from unsuccessful coping with high task demands in everyday life activities. The outcome of the current study underscores the importance of early clinical neuropsychological standardized assessment as well as the diagnosis of cognitive and psychopathological symptoms in adult patients with diabetes.
本研究旨在评估40例1型糖尿病（DM1，n = 28）或2型糖尿病（DM2，n = 12）成年患者（年龄：18 - 60岁）在代谢控制方面的认知、抑郁和焦虑症状。19名年龄、性别和教育程度匹配的健康受试者作为对照组。对于大多数认知领域，糖尿病组受试者与对照受试者之间未发现显著的表现差异。然而，糖尿病患者表现出信息处理准确性降低以及视觉和言语工作记忆表现受损。此外，精神病理学评分显著升高，但未达到抑郁或焦虑的临床标准。总体而言，糖尿病亚组之间没有显著差异，且任一亚组的认知表现、精神病理学评分和糖化血红蛋白（HbA1c）值之间均未发现显著相关性。因此，DM1或DM2患者可能表现出轻度至中度认知障碍以及细微的精神病理学症状。虽然认知障碍可能可从糖尿病相关的认知功能障碍角度来理解，但精神病理学症状也可能是由于在日常生活活动中应对高任务需求失败所致。本研究结果强调了对成年糖尿病患者进行早期临床神经心理学标准化评估以及认知和精神病理学症状诊断的重要性。
