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2 型糖尿病患者与非糖尿病的重性抑郁障碍患者之间抑郁症状群的差异。

Differences in the cluster of depressive symptoms between subjects with type 2 diabetes and individuals with a major depressive disorder and without diabetes.

机构信息

Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain.

Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Barcelona, Spain.

出版信息

J Endocrinol Invest. 2019 Aug;42(8):881-888. doi: 10.1007/s40618-019-01020-x. Epub 2019 Feb 20.

Abstract

BACKGROUND

Depressive disorder encompasses a wide spectrum of somatic and psychological symptoms. It is not known whether there are differences regarding the cluster of depressive symptomatology between subjects with depression with and without T2DM.

PURPOSE

To explore whether the cluster of depression that prevails among depressive subjects with T2DM differs from individuals with depression, but without T2DM.

METHODS

87 T2DM patients with a pathological Beck Depression Inventory test (BDI) were compared with 50 age- and gender-matched individuals with a major depressive disorder. All 21 items expressed in the BDI were compared between the two groups.

RESULTS

The score obtained after administering the BDI was comparable between patients with T2DM and significant depressive symptoms and the control group (18.8 ± 2.7 vs 18.9 ± 3.4; p = 0.9). Subjects with T2DM had higher scores compared with the control group in the following items: sadness (1.4 ± 0.9 vs 0.9 ± 0.9; p = 0.011), difficulty in concentration (1.3 ± 0.8 vs 0.8 ± 0.8; p = 0.01), indecisiveness (1.1 ± 0.8 vs 0.5 ± 0.9; p = 0.012), worries about their health (1.3 ± 0.9 vs 0.6 ± 0.9; p < 0.0001), fatigue (1.2 ± 0.6 vs 0.8 ± 0.7; p = 0.003) and loss of sexual appetite (2.7 ± 0.6 vs 1.2 ± 1.3; p = 0.0001). Suicidal ideation was significantly lower among subjects with T2DM compared with the control group (0.1 ± 0.3 vs 0.6 ± 0.8; p = 0.0001).

CONCLUSIONS

Subjects with T2DM and a positive screening for depression presented a different cluster of depression compared with depressed subjects without T2DM, with a predominance of somatic-biological depressive symptoms rather than psychological-cognitive cluster and negative emotions, such as suicidal ideation.

摘要

背景

抑郁障碍涵盖了广泛的躯体和心理症状。目前尚不清楚患有 2 型糖尿病(T2DM)和不伴 T2DM 的抑郁患者之间,是否存在抑郁症状群的差异。

目的

探讨 T2DM 伴发抑郁患者的抑郁症状群是否与不伴 T2DM 的抑郁患者不同。

方法

对 87 例 T2DM 患者进行病理性贝克抑郁量表(BDI)测试,并与 50 例年龄和性别匹配的有重度抑郁障碍的个体进行比较。比较两组患者的 BDI 全部 21 项。

结果

T2DM 伴显著抑郁症状患者和对照组的 BDI 评分相似(18.8±2.7 vs 18.9±3.4;p=0.9)。与对照组相比,T2DM 患者在以下项目中得分更高:悲伤(1.4±0.9 vs 0.9±0.9;p=0.011)、注意力集中困难(1.3±0.8 vs 0.8±0.8;p=0.01)、犹豫不决(1.1±0.8 vs 0.5±0.9;p=0.012)、担心健康(1.3±0.9 vs 0.6±0.9;p<0.0001)、疲劳(1.2±0.6 vs 0.8±0.7;p=0.003)和性欲下降(2.7±0.6 vs 1.2±1.3;p=0.0001)。与对照组相比,T2DM 患者的自杀意念明显较低(0.1±0.3 vs 0.6±0.8;p=0.0001)。

结论

与不伴 T2DM 的抑郁患者相比,T2DM 合并抑郁筛查阳性的患者表现出不同的抑郁症状群,以躯体生物学抑郁症状为主,而非心理认知集群和自杀意念等负性情绪。

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