Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA.
Albert Einstein College of Medicine, Bronx, NY, USA.
J Behav Med. 2020 Feb;43(1):57-68. doi: 10.1007/s10865-019-00056-x. Epub 2019 May 20.
Depression and anxiety have been linked to increased somatic symptoms among individuals with type 2 diabetes (T2D), but their independent effects and role in symptom attributions remain unclear. This study examined depression and anxiety in relation to total symptoms and symptom attributions in a diverse sample of 120 adults with T2D. Multiple linear regression tested associations after controlling for medical comorbidities and insulin use. Clinician-rated depression (β = .53, p < .001), self-reported depression (β = .59, p < .001) and self-reported anxiety (β = .62, p < .001) were positively associated with total somatic symptoms. Models adjusting for depression and anxiety revealed significant independent effects for each, regardless of measurement method. In attribution models, only self-reported depression (β = .27, p = .003) was significantly associated with greater attribution to diabetes, whereas clinician-rated depression (β = .19, p = .047), self-reported depression (β = .38, p < .001) and anxiety (β = .28, p = .004) were associated with increased attribution to medications. In models adjusting for depression and anxiety, self-reported depression was a significant independent predictor of diabetes (β = .29, p = .023) and medication (β = .38, p = .004) attribution; anxiety was a significant predictor of medication attribution (β = .25, p = .039). Findings suggest depression and anxiety are implicated in overall increases in somatic symptom complaints and an increased tendency to attribute these symptoms to diabetes and side-effects of diabetes medications among adults with T2D.
抑郁和焦虑与 2 型糖尿病（T2D）患者的躯体症状增加有关，但它们的独立影响及其在症状归因中的作用仍不清楚。本研究在一个由 120 名患有 T2D 的不同种族成年人组成的样本中，研究了抑郁和焦虑与总症状和症状归因的关系。多元线性回归在控制了合并症和胰岛素使用后，测试了关联。临床医生评定的抑郁（β=0.53，p<0.001）、自我报告的抑郁（β=0.59，p<0.001）和自我报告的焦虑（β=0.62，p<0.001）与总躯体症状呈正相关。调整抑郁和焦虑的模型显示，每种方法都有显著的独立影响。在归因模型中，只有自我报告的抑郁（β=0.27，p=0.003）与更大的糖尿病归因显著相关，而临床医生评定的抑郁（β=0.19，p=0.047）、自我报告的抑郁（β=0.38，p<0.001）和焦虑（β=0.28，p=0.004）与对药物的归因增加相关。在调整抑郁和焦虑的模型中，自我报告的抑郁是糖尿病（β=0.29，p=0.023）和药物（β=0.38，p=0.004）归因的显著独立预测因子；焦虑是药物归因的显著预测因子（β=0.25，p=0.039）。研究结果表明，抑郁和焦虑与 T2D 成人整体躯体症状抱怨的增加以及将这些症状归因于糖尿病和糖尿病药物副作用的倾向增加有关。
