埃塞俄比亚亚的斯亚贝巴黑狮综合专科医院2型糖尿病门诊患者中与抑郁症相关的社会人口学、临床和心理社会因素：一项横断面研究
Sociodemographic, clinical, and psychosocial factors associated with depression among type 2 diabetic outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study.
作者信息
Habtewold Tesfa Dejenie, Alemu Sisay Mulugeta, Haile Yohannes Gebreegziabhere
机构信息
Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, P.O. BOX: 445, Ethiopia.
International Medical Corps, Mental Health and Psychosocial Support Program, Dollo Ado Refugee Camp, Ethiopia.
出版信息
BMC Psychiatry. 2016 Apr 15;16:103. doi: 10.1186/s12888-016-0809-6.
BACKGROUND
Depression is a common comorbidity among patients with type 2 diabetes. There are several reports supporting a bidirectional association between depression and type 2 diabetes. However, there is limited data from non-western countries. Therefore, the aim of this study was to assess the sociodemographic, clinical, and psychosocial factors associated with co-morbid depression among type 2 diabetic outpatients presenting to Black Lion General Specialized Hospital, Addis Ababa, Ethiopia.
METHODS
This institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients. Type 2 diabetes patients were evaluated for depression by administering a validated nine-item Patient Health Questionnaire (PHQ-9). Risk factors for depression among type 2 diabetes patients were identified using multiple logistic regression analysis.
RESULT
In total, 264 study participants were interviewed with a response rate of 95.6%. The prevalence of depression was 44.7%. In the multivariate analysis, the statistically significant risk factors for depression were monthly family income ≤ 650 (p-value = 0.056; OR = 2.0; 95% CI = 1.01, 4.2), presence of ≥3 diabetic complications (p-value = 0.03; OR = 3.3; 95% CI = 1.1, 10.0), diabetic nephropathy (p-value = 0.01; OR = 2.9; 95% CI = 1.2, 6.7), negative life events (p-value = 0.01; OR = 2.4; 95% CI = 1.2, 4.5), and poor social support (p-value = 0.001; OR = 2.7; 95% CI = 1.5, 5.0).
CONCLUSION
This study demonstrated that depression is a common co-morbid health problem with a prevalence rate of 44.7%. The presence of diabetic complications, low monthly family income, diabetic nephropathy, negative life event, and poor social support were the statistically significant risk factors associated with depression. We presume that the burden of mental health especially depression is high in the population with type 2 diabetes mellitus co-morbidity. Therefore, specific attention is needed to diagnose early and treat promptly.
背景
抑郁症是2型糖尿病患者中常见的合并症。有几份报告支持抑郁症与2型糖尿病之间的双向关联。然而，来自非西方国家的数据有限。因此，本研究的目的是评估在埃塞俄比亚亚的斯亚贝巴黑狮综合专科医院就诊的2型糖尿病门诊患者中，与合并抑郁症相关的社会人口学、临床和心理社会因素。
方法
本研究采用基于机构的横断面研究设计，对276名2型糖尿病门诊患者进行随机抽样。通过使用经过验证的九项患者健康问卷（PHQ-9）对2型糖尿病患者进行抑郁症评估。使用多因素逻辑回归分析确定2型糖尿病患者中抑郁症的危险因素。
结果
总共对264名研究参与者进行了访谈，回复率为95.6%。抑郁症的患病率为44.7%。在多变量分析中，抑郁症的统计学显著危险因素为月家庭收入≤650（p值=0.056；OR=2.0；95%CI=1.01，4.2）、存在≥3种糖尿病并发症（p值=0.03；OR=3.3；95%CI=1.1，10.0）、糖尿病肾病（p值=0.01；OR=2.9；95%CI=1.2，6.7）、负面生活事件（p值=0.01；OR=2.4；95%CI=1.2，4.5）以及社会支持差（p值=0.001；OR=2.7；95%CI=1.5，5.0）。
结论
本研究表明，抑郁症是一种常见的合并健康问题，患病率为44.7%。糖尿病并发症的存在、月家庭收入低、糖尿病肾病、负面生活事件以及社会支持差是与抑郁症相关的统计学显著危险因素。我们推测，2型糖尿病合并症患者的心理健康负担尤其是抑郁症负担较高。因此，需要特别关注早期诊断和及时治疗。
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