Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road, 152-MPD, Menlo Park, CA 94025, United States.
J Psychosom Res. 2018 Mar;106:62-69. doi: 10.1016/j.jpsychores.2018.01.001. Epub 2018 Jan 6.
To examine prevalence, functioning and treatment associated with all DSM-5 12-month mood, anxiety, eating and substance use disorders among people with diabetes in data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions-III.
Through multistage stratified randomized sampling a sample representative of the United States civilian population was obtained. Prevalence of diabetes (Type 1 and 2), DSM-5 disorders, physical and mental functioning, and treatment utilization were assessed via telephone interview. Analyses of weighted data (N=36,138) included calculation of descriptive statistics, and chi-square, logistic and linear regression analyses.
Participants with (vs. without) diabetes (9.3% of weighted sample) had a significantly: (a) higher prevalence of any anxiety disorder and posttraumatic stress disorder (with and without adjustment for sociodemographic characteristics), and any mood disorder, major depressive disorder and specific phobia (with adjustment), (b) lower prevalence of any substance use disorder and alcohol and tobacco use disorders (with and without adjustment), and cannabis use disorder (without adjustment). Among participants with diabetes, mental disorder prevalence was consistently associated with sex and age, and to a lesser frequency, race/ethnicity. Lower levels of physical and mental functioning were found among participants with diabetes and a comorbid mental disorder. A minority of participants with diabetes and a comorbid mental disorder received treatment for mood and anxiety disorders, and few received treatment for eating and substance use disorders.
Multiple types of mood, anxiety, eating and substance use disorders are prevalent, problematic, and often untreated among people with diabetes.
在国家酒精相关情况流行病学调查 III 中获取的数据中,研究所有与 DSM-5 12 个月情绪、焦虑、饮食和物质使用障碍相关的糖尿病患者的患病率、功能和治疗情况。
通过多阶段分层随机抽样,获得了美国平民人口的代表性样本。通过电话访谈评估糖尿病(1 型和 2 型)、DSM-5 障碍、身体和精神功能以及治疗利用的患病率。对加权数据(N=36138)的分析包括描述性统计分析、卡方检验、逻辑回归和线性回归分析。
与无糖尿病者相比(加权样本的 9.3%),有糖尿病者:(a)更易患任何焦虑障碍和创伤后应激障碍(调整与不调整社会人口特征),以及任何心境障碍、重性抑郁障碍和特定恐惧症(调整后),(b)更不易患任何物质使用障碍和酒精及烟草使用障碍(调整与不调整),以及大麻使用障碍(不调整)。在有糖尿病者中,精神障碍的患病率始终与性别和年龄有关,与种族/民族的相关性较低。患有糖尿病和共患精神障碍的参与者的身体和精神功能水平较低。患有糖尿病和共患精神障碍的少数参与者接受了心境和焦虑障碍的治疗,很少有人接受了饮食和物质使用障碍的治疗。
多种类型的情绪、焦虑、饮食和物质使用障碍在糖尿病患者中普遍存在、问题严重,且往往未得到治疗。