Buchberger Barbara, Huppertz Hendrik, Krabbe Laura, Lux Beate, Mattivi Jessica T, Siafarikas Aris
Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany.
Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany.
Psychoneuroendocrinology. 2016 Aug;70:70-84. doi: 10.1016/j.psyneuen.2016.04.019. Epub 2016 Apr 29.
The interaction between psychosocial factors and type 1 diabetes is complex and screening for psychosocial risk factors from diagnosis of type 1 diabetes has been recommended. This is a systematic review and meta-analysis to address the following questions: (1) How prevalent are symptoms of depression and anxiety in children and adolescents with type 1 diabetes? (2) Is there an association of symptoms of depression and anxiety with diabetes management and glycemic control?
We searched EMBASE, MEDLINE, The Cochrane Library, and PsycINFO in April 2014 with an update in May 2015. When possible, data were pooled to estimate summary effects.
14 studies investigated symptoms of depression and anxiety in children and adolescents with type 1 diabetes. The pooled prevalence of depressive symptoms was 30.04%, 95% CI [16.33; 43.74]. There were correlations between symptom levels and glycemic control as well as three-way interactions between HbA1c, blood glucose monitoring frequency or diabetes-specific stress and depression. Symptoms of anxiety were reported for up to 32% of patients. A negative impact on glycemic control was demonstrated.
Our analyses confirmed a high prevalence of symptoms of depression and anxiety in youth with type 1 diabetes that potentially compromise diabetes management and glycemic control. In our opinion these findings support recommendations for early screening for psychological comorbidity and regular psychosocial assessment from diagnosis. Future prospective studies are warranted to further explore the interaction of symptoms of depression and anxiety with type 1 diabetes and develop evidence-based treatment models.
心理社会因素与1型糖尿病之间的相互作用较为复杂，建议从1型糖尿病诊断时就筛查心理社会风险因素。这是一项系统评价和荟萃分析，旨在解决以下问题：（1）1型糖尿病儿童和青少年中抑郁和焦虑症状的患病率有多高？（2）抑郁和焦虑症状与糖尿病管理及血糖控制之间是否存在关联？
我们于2014年4月检索了EMBASE、MEDLINE、Cochrane图书馆和PsycINFO，并于2015年5月进行了更新。尽可能汇总数据以估计汇总效应。
14项研究调查了1型糖尿病儿童和青少年的抑郁和焦虑症状。抑郁症状的汇总患病率为30.04%，95%置信区间为[16.33；43.74]。症状水平与血糖控制之间存在相关性，糖化血红蛋白、血糖监测频率或糖尿病特异性应激与抑郁之间存在三方相互作用。高达32%的患者报告有焦虑症状。已证实对血糖控制有负面影响。
我们的分析证实，1型糖尿病青少年中抑郁和焦虑症状的患病率较高，这可能会影响糖尿病管理和血糖控制。我们认为，这些发现支持从诊断时就进行心理合并症早期筛查和定期心理社会评估的建议。未来有必要进行前瞻性研究，以进一步探讨抑郁和焦虑症状与1型糖尿病之间的相互作用，并建立基于证据的治疗模式。
