Foran E, Hannigan A, Glynn L
Graduate Entry Medical School, University of Limerick, Limerick, Ireland,
Ir J Med Sci. 2015 Jun;184(2):319-22. doi: 10.1007/s11845-014-1110-7. Epub 2014 Apr 11.
As the Irish population ages, the management of chronic conditions in primary care is emerging as a challenge. The presence of co-morbid depression is common among such patients and may affect their response to treatment.
This study sought to determine whether the prevalence of depression is higher in patients with type 2 diabetes mellitus than in the population aged >50 in the West of Ireland, and whether depression is an independent predictor of diabetes control.
We used a cross-sectional design to examine an anonymized database of 9,698 patients aged >50 years whose medical data were collected as part of NUI Galway's CLARITY study. Glycosylated HbA1c levels were used to estimate type 2 DM control; depression was assessed using the Hospital Anxiety and Depression Scale.
We found that while there is a higher prevalence of severe depression in patients with type 2 DM, there is no association between their diabetes control and depression after controlling for age, gender, comorbidity and GMS status. Multimorbidity is a significant predictor of depression in both diabetic and non-diabetic populations, with the odds of depression increasing as the number of co-morbidities increased.
Patients with type 2 DM are more likely to suffer from severe depression than those without. Depression itself is not an independent predictor of diabetes control. However, it may be that the increased rates of depression observed in patients with type 2 DM are at least partially attributable to the burden of additional illnesses seen in these patients.
随着爱尔兰人口老龄化,初级保健中慢性病的管理正成为一项挑战。此类患者中合并抑郁症的情况很常见,可能会影响他们对治疗的反应。
本研究旨在确定2型糖尿病患者中抑郁症的患病率是否高于爱尔兰西部50岁以上人群,以及抑郁症是否是糖尿病控制的独立预测因素。
我们采用横断面设计,研究了一个匿名数据库,该数据库包含9698名50岁以上患者,其医疗数据是作为国立高威大学的CLARITY研究的一部分收集的。糖化血红蛋白A1c水平用于评估2型糖尿病的控制情况;使用医院焦虑抑郁量表评估抑郁症。
我们发现,虽然2型糖尿病患者中重度抑郁症的患病率较高,但在控制年龄、性别、合并症和基层医疗服务状态后,他们的糖尿病控制与抑郁症之间没有关联。在糖尿病和非糖尿病人群中,多种合并症都是抑郁症的重要预测因素,抑郁症的几率随着合并症数量的增加而增加。
2型糖尿病患者比非糖尿病患者更容易患重度抑郁症。抑郁症本身并不是糖尿病控制的独立预测因素。然而,2型糖尿病患者中观察到的抑郁症发病率增加可能至少部分归因于这些患者中额外疾病的负担。