Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, the Netherlands; Tilburg University, Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg, the Netherlands; Diabeter, National treatment and research center for children, adolescents and young adults with type 1 diabetes, Rotterdam, the Netherlands.
Deakin University, School of Psychology, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.
J Diabetes Complications. 2019 Aug;33(8):523-529. doi: 10.1016/j.jdiacomp.2019.04.013. Epub 2019 Apr 28.
We examined: (a) the prevalence of comorbid elevated symptoms of anxiety/depression; (b) its demographic/clinical correlates; (c) associations with self-care behaviors, by diabetes type.
Cross-sectional self-report data of 6590 adults with diabetes (42% type 1; 58% type 2) from the Australian and Dutch Diabetes MILES studies were used. Elevated symptoms of anxiety/depression were defined as GAD-7 ≥ 10/PHQ-9 ≥ 10.
In both diabetes types, comorbid elevated symptoms of anxiety/depression were present in 9% and symptoms of anxiety alone in 2%; symptoms of depression alone were present in 8% of adults with type 1 diabetes and 11% with type 2 diabetes. Shorter diabetes duration (type 1 only) was the only characteristic that distinguished those with comorbid elevated symptoms of anxiety/depression but not those with symptoms of anxiety/depression alone from the reference group (no/minimal symptoms of anxiety/depression). Those with comorbid elevated symptoms of anxiety/depression had increased odds of sub-optimal diabetes self-care behaviors compared with the reference group, with higher odds than those with symptoms of anxiety or depression alone.
Comorbid elevated symptoms of anxiety/depression affected one in ten respondents, who also had increased odds of suboptimal diabetes self-care. Those with shorter type 1 diabetes duration may be at increased risk.
我们研究了:(a) 焦虑/抑郁共病症状升高的患病率;(b) 其与人口统计学/临床相关的因素;(c) 按糖尿病类型与自我护理行为的关联。
使用来自澳大利亚和荷兰糖尿病 MILES 研究的 6590 名成年糖尿病患者(42%为 1 型;58%为 2 型)的横断面自我报告数据。焦虑/抑郁共病症状升高定义为 GAD-7≥10/PHQ-9≥10。
在这两种类型的糖尿病中,焦虑/抑郁共病症状升高的患病率均为 9%,单独出现焦虑症状的患病率为 2%;单独出现抑郁症状的患病率为 1 型糖尿病患者 8%,2 型糖尿病患者 11%。较短的糖尿病病程(仅 1 型)是区分同时存在焦虑/抑郁共病症状和仅存在焦虑/抑郁症状与无/轻度焦虑/抑郁症状参考组的唯一特征。与参考组相比,同时存在焦虑/抑郁共病症状升高的患者自我护理行为更差,且其发生几率高于仅存在焦虑或抑郁症状的患者。
焦虑/抑郁共病症状升高影响十分之一的受访者,他们也更有可能自我护理不佳。1 型糖尿病病程较短的患者可能面临更高的风险。