Lara Muñoz María del Carmen, Jacobs Elizabeth A, Escamilla Marco Antonio, Mendenhall Emily
Facultad de Medicina, Benemérita Universidad Autónoma de Puebla México, Puebla, Mexico.
Health Innovation and Population Studies, School of Medicin, University of Wisconsin-Madison.
Rev Panam Salud Publica. 2014 Oct;36(4):225-31.
To compare the prevalence and patterns of depressive symptoms among women with type 2 diabetes in Puebla, Mexico, and Chicago, United States.
Two cross-sectional studies were conducted independently, in Puebla (September 2010-March 2011) and in Chicago (January-July 2010). Depression symptomatology was evaluated in a random sample of 241 women self-reporting type 2 diabetes in Puebla and a convenience sample of 121 women of Mexican descent seeking care for type 2 diabetes in Chicago. Depressive symptomatology was measured by the Center for Epidemiologic Studies Depression Scale administered in either English or Spanish. Women were similarly socioeconomically disadvantaged with low education levels in both locations.
The Chicago sample of women reported higher levels of depression than the Puebla sample (38% versus 17%, P < 0.0001). Among those with comorbid depression and diabetes in both sites, minimal variations in symptoms were observed. Depressive symptoms, specifically the subjective element (feeling sad) and symptoms associated with diabetes (fatigue and sleep problems) were heightened in both groups. More frequent reporting of "feeling fearful" was statistically significant in Puebla.
Despite a higher prevalence of depression among Mexican immigrant women with diabetes in the United States compared to Mexico, there was little variation in their depressive symptoms, regardless of residence. However, women in Mexico did report a higher incidence of fear. Screening for depression in patients with diabetes should take into account symptoms of fatigue and sleep and the bi-directional relationship of depression and diabetes.
比较墨西哥普埃布拉和美国芝加哥2型糖尿病女性患者抑郁症状的患病率及模式。
分别在普埃布拉（2010年9月至2011年3月）和芝加哥（2010年1月至7月）独立开展两项横断面研究。对普埃布拉随机抽取的241名自述患有2型糖尿病的女性以及芝加哥121名寻求2型糖尿病治疗的墨西哥裔女性便利样本进行抑郁症状评估。采用流行病学研究中心抑郁量表以英语或西班牙语进行抑郁症状测量。两地女性在社会经济方面均处于不利地位且教育水平较低。
芝加哥女性样本报告的抑郁水平高于普埃布拉样本（38%对17%，P<0.0001）。在两地患有共病性抑郁和糖尿病的患者中，症状差异极小。两组中抑郁症状，特别是主观因素（感到悲伤）以及与糖尿病相关的症状（疲劳和睡眠问题）均有所加重。在普埃布拉，“感到恐惧”的报告频率更高，具有统计学意义。
尽管在美国患糖尿病的墨西哥移民女性中抑郁症患病率高于墨西哥，但无论居住地点如何，她们的抑郁症状差异不大。然而，墨西哥女性确实报告了更高的恐惧发生率。对糖尿病患者进行抑郁症筛查时应考虑疲劳和睡眠症状以及抑郁与糖尿病的双向关系。
