Davis Timothy M E, Hunt Kerry, Bruce David G, Starkstein Sergio, Skinner Timothy, McAullay Daniel, Davis Wendy A
University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
Diabetes Res Clin Pract. 2015 Mar;107(3):384-91. doi: 10.1016/j.diabres.2014.12.014. Epub 2015 Jan 21.
To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes.
Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression.
The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9; these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group.
Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk.
确定澳大利亚原住民和英裔凯尔特人（AC）2型糖尿病患者中抑郁症的患病率及相关因素。
作为详细评估的一部分，使用患者健康问卷（PHQ-9）对社区患者进行筛查。在对年龄、性别、教育程度和婚姻状况进行调整后，比较不同种族组当前任何抑郁症、重度抑郁症和抗抑郁药使用情况的患病率。采用多因素逻辑回归分析确定当前抑郁症的相关因素。
107名原住民参与者比793名AC受试者更年轻（平均±标准差 54.3±11.8岁 vs. 67.2±10.6岁），男性比例更低（34.6% vs. 50.9%），已婚比例更低（39.3% vs. 61.7%），且吸烟可能性更高（44.6% vs. 8.1%）（P≤0.002）。52名原住民（48.5%）和772名AC参与者（97.4%）完成了PHQ-9；这些原住民在社会人口统计学、人体测量学和糖尿病相关特征方面与未提供PHQ-9数据的人相似。四分之一的原住民患有当前抑郁症，而AC患者为10.6%（P=0.16），重度抑郁症患者分别为15.4%和4.1%（P=0.029），未治疗抑郁症患者分别为68.8%和29.7%（P=0.032）。与未患抑郁症的参与者相比，当前患有抑郁症的患者更年轻，吸烟、超重/肥胖的可能性更高，血糖控制更差（P≤0.024）。AC组当前抑郁症的显著独立相关因素为教育程度（呈负相关）、吸烟状况、体重指数和空腹血糖，原住民组为饮酒情况。
虽然原住民患者抑郁症的患病率没有显著增加，但更可能是重度且未治疗的。2型糖尿病并发抑郁症与不良心血管风险相关。
