Department of Psychiatry, University Health Network, Toronto, ON, Canada.
Pediatr Diabetes. 2013 Aug;14(5):372-6. doi: 10.1111/pedi.12016. Epub 2013 Feb 19.
Depression and disturbed eating behavior (DEB) are more common in girls with type 1 diabetes (T1D) than in the general population, and may negatively affect metabolic control.
To examine the relationship among depression, DEB, and metabolic control in teenage girls with T1D.
Metabolic control, body mass index and interview-ascertained symptoms of depression, and DEB were assessed twice in 98 girls with T1D, 9-14 y at baseline and 5 yr later at 14-18 yr.
At year 5, 12.2% of girls reported current depressive symptoms, 49.0% reported current DEB, and 13.3% had a full or subthreshold eating disorder (ED). Eating Disorder Examination score was higher in girls with depression (1.4 ± 1.3 vs. 0.5 ± 0.7; p = 0.03), and 75.0% of girls with depression also endorsed DEB vs. 45.3% of girls without depression (p = 0.05). Girls with an ED were at high risk for depressive symptoms; 69.2% reported depressive symptoms vs. 22.0% of girls with no DEB (p = 0.004). Metabolic control was not significantly associated with either depression or DEB in this cohort. A regression model using baseline and year 5 depression and DEB to predict year 5 hemoglobin A1c was not significant overall.
Depression and DEB were common and frequently concurrent in this cohort. It was encouraging that poor metabolic control was not yet strongly associated with either depression or DEB. Early detection and treatment may help to prevent the development of entrenched difficulties in this triad of mood, eating behavior, and metabolic control in a vulnerable population.
与普通人群相比，1 型糖尿病（T1D）女孩更常出现抑郁和饮食行为紊乱（DEB），这可能会对代谢控制产生负面影响。
探讨 T1D 少女抑郁、DEB 与代谢控制之间的关系。
在 98 名 T1D 少女中，两次评估代谢控制、体重指数和访谈确定的抑郁症状以及 DEB，基线为 9-14 岁，5 年后为 14-18 岁。
在第 5 年，12.2%的女孩报告有当前的抑郁症状，49.0%报告有当前的 DEB，13.3%有完全或亚阈值饮食障碍（ED）。有抑郁的女孩的饮食障碍检查评分更高（1.4 ± 1.3 与 0.5 ± 0.7；p = 0.03），75.0%的抑郁女孩也有 DEB，而无抑郁的女孩为 45.3%（p = 0.05）。有 ED 的女孩患抑郁的风险较高；69.2%报告有抑郁症状，而无 DEB 的女孩为 22.0%（p = 0.004）。在该队列中，代谢控制与抑郁或 DEB 均无显著相关性。使用基线和第 5 年的抑郁和 DEB 预测第 5 年糖化血红蛋白的回归模型总体上并不显著。
在该队列中，抑郁和 DEB 很常见且经常同时发生。令人鼓舞的是，代谢控制不佳尚未与抑郁或 DEB 密切相关。在这一易受影响的人群中，早期发现和治疗可能有助于预防这三者（情绪、饮食行为和代谢控制）中根深蒂固的困难的发展。
