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社会支持是否会调节糖尿病成年患者中重度抑郁症、广泛性焦虑症和功能残疾之间的关联?

Does Social Support Moderate the Association Among Major Depression, Generalized Anxiety Disorder, and Functional Disability in Adults With Diabetes?

作者信息

Levy Melanie, Burns Rachel J, Deschênes Sonya S, Schmitz Norbert

机构信息

Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.

Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.

出版信息

Psychosomatics. 2017 Jul-Aug;58(4):364-374. doi: 10.1016/j.psym.2017.03.004. Epub 2017 Mar 6.

Abstract

BACKGROUND

Diabetes requires complex self-management routines to prevent the development of functional disability. Relative to people without diabetes, those with diabetes are more likely to have comorbid major depressive disorder (MDD) and generalized anxiety disorder (GAD), which also increase the likelihood of functional disability. Social support is associated with positive health outcomes in people with comorbid diabetes and mental disorders and may serve as a buffer against functional disability, though this possibility has yet to be examined.

OBJECTIVES

This study examined whether social support moderates the association between MDD or GAD and functional disability in adults with diabetes. Adults with MDD or GAD were expected to report greater disability than those without MDD or GAD. This association was expected to be stronger in people reporting lower social support relative to those reporting higher social support.

METHODS

Data came from the cross-sectional 2012 Canadian Community Health Survey-Mental Health (n = 1764). Diabetes status, social support, and functional disability were assessed via self-report; past-year MDD and GAD were assessed with structured diagnostic interviews.

RESULTS

Linear regression analyses, conducted separately for MDD and GAD, indicated main effects of past-year MDD and GAD, such that those with a mental disorder reported greater functional disability than those without a mental disorder. Social support did not moderate the associations between either MDD and functional disability or GAD and functional disability.

CONCLUSIONS

In this nationally representative population study, both MDD and GAD predicted greater functional disability in adults with diabetes. Social support, however, did not moderate these associations.

摘要

背景

糖尿病需要复杂的自我管理程序来预防功能残疾的发生。与没有糖尿病的人相比,糖尿病患者更有可能合并重度抑郁症(MDD)和广泛性焦虑症(GAD),这也增加了功能残疾的可能性。社会支持与合并糖尿病和精神障碍的人的积极健康结果相关,并且可能作为功能残疾的缓冲因素,尽管这种可能性尚未得到研究。

目的

本研究调查了社会支持是否调节糖尿病成年人中MDD或GAD与功能残疾之间的关联。预计患有MDD或GAD的成年人比没有MDD或GAD的成年人报告的残疾程度更高。相对于报告社会支持较高的人,预计这种关联在报告社会支持较低的人中更强。

方法

数据来自2012年加拿大社区健康调查-心理健康横断面研究(n = 1764)。通过自我报告评估糖尿病状态、社会支持和功能残疾;通过结构化诊断访谈评估过去一年的MDD和GAD。

结果

分别对MDD和GAD进行的线性回归分析表明,过去一年的MDD和GAD有主要影响,即患有精神障碍的人比没有精神障碍的人报告的功能残疾程度更高。社会支持并未调节MDD与功能残疾之间或GAD与功能残疾之间的关联。

结论

在这项具有全国代表性的人群研究中,MDD和GAD都预测糖尿病成年人的功能残疾程度更高。然而,社会支持并未调节这些关联。

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