Kim Miyong To, Kim Kim Byeng, Ko Jisook, Jang Yuri, Levine David, Lee Hochang Benjamin
School of Nursing , University of Texas at Austin, Austin, Texas , USA.
Korean Resource Center , Ellicott City, Maryland , USA.
BMJ Open Diabetes Res Care. 2017 Mar 24;5(1):e000337. doi: 10.1136/bmjdrc-2016-000337. eCollection 2017.
Comorbid depression and diabetes mellitus (DM) compound challenges to disease management such as low health literacy, insufficient access to care, and social or linguistic isolation. Korean Americans (KAs), predominantly first-generation immigrants, suffer from a high prevalence of type 2 DM and depression. Limited research on KAs has prevented the development of effective interventions.
To compare the prevalence of depression in KAs with DM and all Americans with/without DM, and to explore correlates of comorbid DM and depression and strategies to address KAs' DM and depression.
KAs' data were from a clinical trial of a community-based self-help intervention to improve KAs' DM and mental health outcomes. National Health and Nutrition Examination Survey data sets enabled comparison. Clinical indicators included hemoglobin A1C, lipid panel, and body mass index. Psychobehavioral indicators included self-efficacy for DM management, quality of life, and depression (Patient Health Questionnaire-9 (PHQ-9)).
More KAs with DM had depression (44.2%) than did all Americans with DM (28.7%) or without DM (20.1%). Significantly more KAs with DM had mild (29.3%) or clinical (14.9%) depression than did Americans with DM (mild, 17.2%; clinical, 11.5%) or without (mild, 13.8%; clinical, 6.3%). One of six KAs with DM (16.9%) thought of suicide or self-harm (Americans with/without =5.0%, 2.8%). The self-help intervention reduced the mean PHQ-9 from 5.4 at baseline to 4.1 at 12 months.
External validity might be limited; KAs' data were from one study site.
The prevalence of depression and DM among KAs warrants the development of efficacious interventions.
NCT01264796.
抑郁症与糖尿病（DM）并存给疾病管理带来了诸多挑战，如健康素养低、医疗服务获取不足以及社会或语言隔离等问题。韩裔美国人（KAs）大多是第一代移民，2型糖尿病和抑郁症的患病率很高。针对韩裔美国人的研究有限，阻碍了有效干预措施的开发。
比较患有糖尿病的韩裔美国人与所有患有/未患有糖尿病的美国人中抑郁症的患病率，并探讨糖尿病与抑郁症并存的相关因素以及应对韩裔美国人糖尿病和抑郁症的策略。
韩裔美国人的数据来自一项基于社区的自助干预临床试验，旨在改善韩裔美国人的糖尿病和心理健康状况。利用国家健康和营养检查调查数据集进行比较。临床指标包括糖化血红蛋白、血脂谱和体重指数。心理行为指标包括糖尿病管理的自我效能感、生活质量和抑郁症（患者健康问卷-9（PHQ-9））。
患有糖尿病的韩裔美国人中抑郁症患者的比例（44.2%）高于所有患有糖尿病的美国人（28.7%）或未患糖尿病的美国人（20.1%）。患有糖尿病的韩裔美国人中轻度（29.3%）或临床（14.9%）抑郁症患者的比例显著高于患有糖尿病的美国人（轻度，17.2%；临床，11.5%）或未患糖尿病的美国人（轻度，13.8%；临床，6.3%）。每六名患有糖尿病的韩裔美国人中就有一人（16.9%）曾有自杀或自残念头（患有/未患糖尿病的美国人为5.0%，2.8%）。自助干预使平均PHQ-9评分从基线时的5.4降至12个月时的4.1。
外部效度可能有限；韩裔美国人的数据来自一个研究地点。
韩裔美国人中抑郁症和糖尿病的患病率表明有必要开发有效的干预措施。
NCT01264796。
