Stoop Corinne H, Nefs Giesje, Pop Victor J, Pouwer François
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands; PoZoB, PO Box 312, 5500 AH Veldhoven, The Netherlands.
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands.
Prim Care Diabetes. 2017 Jun;11(3):273-280. doi: 10.1016/j.pcd.2017.02.006. Epub 2017 Mar 18.
This study investigated (factors related to) (a) the response to a screening procedure for depression and anxiety in people with type 2 diabetes in primary care, and (b) participation in a subsequent randomised controlled trial targeting depressive or anxiety symptoms.
People with type 2 diabetes (n=1837) received a screening questionnaire assessing depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7). Eligible persons who scored above the cut-off score (PHQ-9≥7 or GAD-7≥8) were offered to participate in the trial.
In total, 798 people (43%) returned the screening questionnaire. Non-responders were more often female (53% vs 44%, p<0.001), had higher LDL cholesterol levels (Cohen's d=0.17, p=0.001) and a higher albumin/creatinine ratio (Cohen's d=0.08, p=0.01). In total, 130 people (18%) reported elevated depressive or anxiety symptoms. Twenty-seven persons agreed to participate in the trial. Factors related to participation were a high education level, a higher level of diabetes distress and a history of psychological problems.
Using screening as recruitment resulted in a small number of participants in a treatment trial for anxiety and depression. Research is needed to investigate whether screening is also followed by a low uptake of treatment in primary care outside a RCT setting.
本研究调查了（与以下因素相关）(a) 初级保健中 2 型糖尿病患者对抑郁和焦虑筛查程序的反应，以及 (b) 参与后续针对抑郁或焦虑症状的随机对照试验的情况。
2 型糖尿病患者（n = 1837）接受了一份筛查问卷，评估抑郁症状（PHQ - 9）和焦虑症状（GAD - 7）。得分高于临界值（PHQ - 9≥7 或 GAD - 7≥8）的符合条件者被邀请参加试验。
共有 798 人（43%）返回了筛查问卷。未回复者女性比例更高（53% 对 44%，p < 0.001），低密度脂蛋白胆固醇水平更高（科恩 d 值 = 0.17，p = 0.001），白蛋白/肌酐比值更高（科恩 d 值 = 0.08，p = 0.01）。共有 130 人（18%）报告有抑郁或焦虑症状升高。27 人同意参加试验。与参与相关的因素包括高教育水平、更高的糖尿病痛苦程度和心理问题史。
将筛查用作招募方式导致治疗焦虑和抑郁试验的参与者数量较少。需要开展研究来调查在随机对照试验环境之外的初级保健中，筛查后是否也存在治疗接受率低的情况。
