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抑郁伴有糖尿病患者的抑郁症状类型是否与患者对专业心理保健的需求有关?

Is type of depressive symptoms associated with patient-perceived need for professional psychological care in depressed individuals with diabetes?

机构信息

Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands.

出版信息

PLoS One. 2019 Feb 14;14(2):e0212304. doi: 10.1371/journal.pone.0212304. eCollection 2019.

Abstract

AIMS

The objective of this study is to investigate whether type of depressive symptoms (i.e. cognitive-affective or somatic) is related to a patient-perceived need for professional psychological care in individuals with diabetes.

METHODS

In total 2266 participants were recruited as part of the screening procedure for a multi-center randomized controlled trial on the treatment of depressive symptoms among individuals with diabetes. Individuals were invited to complete Beck Depression Inventory-II (BDI-II). Patients with elevated depressive symptoms (BDI-II ≥14) were interviewed about their psychological care need. Based on their care needs patients were categorized into: unmet need, no need, met need and unclear need. These groups were compared on type of depressive symptoms, as categorized into cognitive-affective symptoms and somatic symptoms.

RESULTS

568 eligible individuals had elevated depressive symptoms, of whom 519 were reached. Among these depressed individuals, 19.7% (102 of 519) had an unmet need for psychological care. Participants with an unmet need were younger (p<0.001) and had higher total depression scores compared to the group with no need (p<0.001). They also scored higher on cognitive-affective symptoms (p<0.001), whereas somatic symptoms did not significantly differ (p = 0.232). Logistic regression revealed that cognitive-affective symptoms predicted an unmet need (p = 0.001). However, overall predictive capacity of type of depressive symptoms on care needs was weak.

CONCLUSIONS

Cognitive-affective symptoms of depression-but not somatic symptoms-were associated with an unmet need for psychological care among depressed individuals with diabetes. Future research is needed to reveal better predictors explaining the discrepancy between distress and low care needs in order to optimize screening procedures.

摘要

目的

本研究旨在探讨抑郁症状的类型(即认知情感或躯体)是否与糖尿病患者对专业心理护理的需求相关。

方法

本研究共招募了 2266 名参与者,作为一项多中心随机对照试验的筛选程序的一部分,该试验旨在治疗糖尿病患者的抑郁症状。参与者被邀请完成贝克抑郁量表第二版(BDI-II)。出现抑郁症状升高(BDI-II≥14)的患者接受关于其心理护理需求的访谈。根据他们的护理需求,患者被分为:未满足需求、无需求、满足需求和不明确需求。将这些组与抑郁症状的类型进行比较,分为认知情感症状和躯体症状。

结果

共有 568 名符合条件的个体出现抑郁症状升高,其中 519 名接受了访谈。在这些抑郁个体中,19.7%(102/519)有未满足的心理护理需求。未满足需求的参与者年龄较小(p<0.001),且与无需求组相比,总抑郁评分更高(p<0.001)。他们在认知情感症状上的得分也更高(p<0.001),而躯体症状则没有显著差异(p=0.232)。逻辑回归显示,认知情感症状预测了未满足的需求(p=0.001)。然而,抑郁症状类型对护理需求的整体预测能力较弱。

结论

抑郁的认知情感症状——而非躯体症状——与糖尿病患者的心理护理未满足需求相关。需要进一步研究,以揭示更好的预测因素,以解释痛苦与低护理需求之间的差异,从而优化筛选程序。

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