van Dooren Fleur E P, Denollet Johan, Verhey Frans R J, Stehouwer Coen D A, Sep Simone J S, Henry Ronald M A, Kremers Stef P J, Dagnelie Pieter C, Schaper Nicolaas C, van der Kallen Carla J H, Koster Annemarie, Pouwer Frans, Schram Miranda T
Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG, Maastricht, The Netherlands.
Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
BMC Psychiatry. 2016 Jan 27;16:17. doi: 10.1186/s12888-016-0722-z.
Strong longitudinal evidence exists that psychological distress is associated with a high morbidity and mortality risk in type 2 diabetes. Little is known about the biological and behavioral mechanisms that may explain this association. Moreover, the role of personality traits in these associations is still unclear. In this paper, we first describe the design of the psychological part of The Maastricht Study that aims to elucidate these mechanisms. Next, we present exploratory results on the prevalence of depression, anxiety and personality traits in type 2 diabetes. Finally, we briefly discuss the importance of these findings for clinical research and practice.
We measured psychological distress and depression using the MINI diagnostic interview, the PHQ-9 and GAD-7 questionnaires in the first 864 participants of The Maastricht Study, a large, population-based cohort study. Personality traits were measured by the DS14 and Big Five personality questionnaires. Type 2 diabetes was assessed by an oral glucose tolerance test. Logistic regression analyses were used to estimate the associations of depression, anxiety and personality with type 2 diabetes, adjusted for age, sex and education level.
Individuals with type 2 diabetes had higher levels of depressive and anxiety symptoms, odds ratios (95 % CI) were 3.15 (1.49; 6.67), 1.73 (0.83-3.60), 1.50 (0.72-3.12), for PHQ-9 ≥ 10, current depressive disorder and GAD-7 ≥ 10, respectively. Type D personality, social inhibition and negative affectivity were more prevalent in type 2 diabetes, odds ratios were 1.95 (1.23-3.10), 1.35 (0.93-1.94) and 1.70 (1.14-2.51), respectively. Individuals with type 2 diabetes were less extraverted, less conscientious, less agreeable and less emotionally stable, and similar in openness to individuals without type 2 diabetes, although effect sizes were small.
Individuals with type 2 diabetes experience more psychological distress and have different personality traits compared to individuals without type 2 diabetes. Future longitudinal analyses within The Maastricht Study will increase our understanding of biological and behavioral mechanisms that link psychological distress to morbidity and mortality in type 2 diabetes.
有充分的纵向证据表明，心理困扰与2型糖尿病的高发病率和高死亡率风险相关。对于可能解释这种关联的生物学和行为机制，我们知之甚少。此外，人格特质在这些关联中的作用仍不明确。在本文中，我们首先描述了马斯特里赫特研究中心理学部分的设计，该研究旨在阐明这些机制。接下来，我们展示了2型糖尿病患者中抑郁症、焦虑症和人格特质患病率的探索性结果。最后，我们简要讨论了这些发现对临床研究和实践的重要性。
我们在马斯特里赫特研究的首批864名参与者中，使用MINI诊断访谈、PHQ-9和GAD-7问卷来测量心理困扰和抑郁程度。人格特质通过DS14和大五人格问卷进行测量。2型糖尿病通过口服葡萄糖耐量试验进行评估。采用逻辑回归分析来估计抑郁、焦虑和人格与2型糖尿病之间的关联，并对年龄、性别和教育水平进行了校正。
2型糖尿病患者的抑郁和焦虑症状水平更高，对于PHQ-9≥10、当前患有抑郁症和GAD-7≥10的情况，优势比（95%置信区间）分别为3.15（1.49；6.67）、1.73（0.83 - 3.60）、1.50（0.72 - 3.12）。D型人格、社交抑制和消极情感性在2型糖尿病患者中更为普遍，优势比分别为1.95（1.23 - 3.10）、1.35（0.93 - 1.94）和1.70（1.14 - 2.51）。2型糖尿病患者在性格上更内向、更缺乏责任心、更不随和且情绪更不稳定，在开放性方面与非2型糖尿病患者相似，尽管效应量较小。
与非2型糖尿病患者相比，2型糖尿病患者经历更多的心理困扰，且具有不同的人格特质。马斯特里赫特研究未来的纵向分析将增进我们对心理困扰与2型糖尿病发病率和死亡率之间联系的生物学和行为机制的理解。
