Dipartimento di Medicina Interna, Laboratorio di Pedagogia Clinica, Università di Torino, Corso AM Dogliotti 14, 10126, Turin, Italy.
Acta Diabetol. 2012 Jun;49(3):199-203. doi: 10.1007/s00592-011-0275-z. Epub 2011 Mar 27.
To evaluate the prevalence of depression in outpatients with type 2 diabetes and its possible correlation with anxiety, cognitive function, and clinical variables. The Zung Self-Rating Depression and Anxiety Scales and the Mini-Mental-State Examination were administered to 249 non-insulin-treated (NIT) and 249 insulin-treated (IT) outpatients with type 2 diabetes, aged 40-80, in a cross-sectional survey. Compared with a reported prevalence of 6-13% in the general population, 104 (20.9%) patients had either a score indicative of depression or were on anti-depressant medication. Assuming that medication might modify the responses to questionnaires, the latter patients were excluded from further analysis. IT patients had higher age, known duration of diabetes, HbA1c, more foot ulcers, retinopathy, microalbuminuria and practised more self-monitoring of blood glucose (P < 0.01 all) but a slightly lower mean depression score (P = 0.004) and similar anxiety or cognitive function. At multivariate analysis, depression was associated with anxiety (P < 0.001), age (P < 0.001), gender (men having lower scores than women, P = 0.042), and insulin treatment, IT patients being less depressed than NIT (P < 0.001), but none of the clinical variables. Anxiety correlated with age (P < 0.001). The association between depression and anxiety became progressively weaker with increasing age. These data confirm increased prevalence of depression in a population of patients with type 2 diabetes who did not show impaired cognitive function. The lack of correlation with disease duration, metabolic control, and complications suggests that depression may not appear/worsen with diabetes and/or its complications but rather supports suggestions that it might predate both.
评估 2 型糖尿病门诊患者中抑郁的患病率及其与焦虑、认知功能和临床变量的可能相关性。采用zung 自评抑郁和焦虑量表及简易精神状态检查对 249 名非胰岛素治疗（NIT）和 249 名胰岛素治疗（IT）的 2 型糖尿病门诊患者进行横断面调查，患者年龄 40-80 岁。与一般人群中 6-13%的报道患病率相比，104 名患者（20.9%）存在抑郁评分或正在服用抗抑郁药物。由于药物治疗可能会改变对问卷的反应，因此将这些患者排除在进一步分析之外。IT 患者的年龄、已知糖尿病病程、糖化血红蛋白（HbA1c）、足部溃疡、视网膜病变、微量白蛋白尿更高，自我血糖监测更多（均 P < 0.01），但平均抑郁评分略低（P = 0.004），焦虑或认知功能相似。多变量分析显示，抑郁与焦虑相关（P < 0.001）、年龄相关（P < 0.001）、性别相关（男性评分低于女性，P = 0.042）、与胰岛素治疗相关（与 NIT 相比，IT 患者抑郁程度较低，P < 0.001），但与临床变量无关。焦虑与年龄相关（P < 0.001）。抑郁与焦虑之间的相关性随年龄的增加而逐渐减弱。这些数据证实，在未出现认知功能障碍的 2 型糖尿病患者人群中，抑郁的患病率增加。与病程、代谢控制和并发症无关表明，抑郁可能不会随着糖尿病及其并发症的发生而出现/恶化，而是支持了抑郁可能早于糖尿病及其并发症出现的观点。
