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早发型2型糖尿病成人患者的糖尿病困扰、感知压力及抑郁症状的患病率及其相关因素:丹麦DD2研究的横断面调查结果

Prevalence and correlates of diabetes distress, perceived stress and depressive symptoms among adults with early-onset Type 2 diabetes: cross-sectional survey results from the Danish DD2 study.

作者信息

Bo A, Pouwer F, Juul L, Nicolaisen S K, Maindal H T

机构信息

Department of Public Health, Aarhus University, Aarhus, Denmark.

Danish Diabetes Academy, Odense, Denmark.

出版信息

Diabet Med. 2020 Oct;37(10):1679-1687. doi: 10.1111/dme.14087. Epub 2019 Aug 16.

Abstract

AIMS

To establish the prevalence of diabetes distress, perceived stress and depressive symptoms among adults with early-onset Type 2 diabetes, and to examine their association with socio-demographic and clinical characteristics.

METHODS

A cross-sectional survey was performed among individuals with Type 2 diabetes aged 20-45 years who were included in the Danish nationwide Danish Center for Strategic Research in Type 2 Diabetes cohort between 2010 and 2016. The survey assessed diabetes distress (20-item Problem Areas in Diabetes Scale), perceived stress (10-item Perceived Stress Scale) and depressive symptoms (10-item short form of the Center for Epidemiological Studies Depression Scale Revised), as well as socio-demographic characteristics. Clinical data were collected from national health registers.

RESULTS

In total, 216/460 (47%) individuals (48% women) with Type 2 diabetes completed the survey. The median (IQR) age was 42 (38-44) years and the diabetes duration was 5 (3-7) years. In total, 24% of respondents reported high diabetes distress (Problem Areas in Diabetes Scale ≥ 40), 46% reported high perceived stress (Perceived Stress Scale ≥ 18) and 41% reported elevated symptoms of depression (Center for Epidemiological Studies Depression Scale Revised ≥ 10). The prevalence of emotional problems was higher among women than men. Diabetes distress was higher among those prescribed non-insulin glucose-lowering drugs (vs. no glucose-lowering drugs), but was not associated with other clinical or socio-demographic characteristics. High perceived stress was associated with being unemployed and using antidepressant medication, and elevated depressive symptoms were associated with low education level, unemployment, living alone, having a psychiatric disorder and using antidepressant medication.

CONCLUSION

We found a high prevalence of emotional problems among adults with early-onset Type 2 diabetes in Denmark. Health care for this group should focus on both physical health and psychosocial circumstances and should also address general as well as diabetes-specific emotional problems.

摘要

目的

确定早发型2型糖尿病成人患者中糖尿病困扰、感知压力和抑郁症状的患病率,并研究它们与社会人口学及临床特征之间的关联。

方法

对2010年至2016年间纳入丹麦全国性2型糖尿病战略研究中心队列的20至45岁2型糖尿病患者进行了一项横断面调查。该调查评估了糖尿病困扰(20项糖尿病问题领域量表)、感知压力(10项感知压力量表)和抑郁症状(流行病学研究中心抑郁量表修订版的10项简表),以及社会人口学特征。临床数据从国家健康登记处收集。

结果

共有216/460(47%)名2型糖尿病患者(48%为女性)完成了调查。年龄中位数(四分位间距)为42(38 - 44)岁,糖尿病病程为5(3 - 7)年。总体而言,24%的受访者报告有高度糖尿病困扰(糖尿病问题领域量表≥40),46%报告有高度感知压力(感知压力量表≥18),41%报告有抑郁症状加重(流行病学研究中心抑郁量表修订版≥10)。女性的情绪问题患病率高于男性。使用非胰岛素降糖药物的患者糖尿病困扰程度更高(与未使用降糖药物的患者相比),但与其他临床或社会人口学特征无关。高度感知压力与失业及使用抗抑郁药物有关,抑郁症状加重与低教育水平、失业、独居、患有精神疾病及使用抗抑郁药物有关。

结论

我们发现丹麦早发型2型糖尿病成人患者中情绪问题的患病率很高。该群体的医疗保健应关注身体健康和心理社会状况,还应解决一般及糖尿病特异性的情绪问题。

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