Yasui-Furukori Norio, Murakami Hiroshi, Otaka Hideyuki, Nakayama Hirofumi, Murabayashi Masaya, Mizushiri Satoru, Matsumura Koki, Tanabe Jutaro, Matsuhashi Yuki, Yanagimachi Miyuki, Nakamura Kazuhiko, Daimon Makoto, Sugawara Norio
1Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
4Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Shimotsuga, Tochigi Japan.
Ann Gen Psychiatry. 2019 Jul 17;18:11. doi: 10.1186/s12991-019-0235-5. eCollection 2019.
Type 2 diabetes mellitus (T2DM) is associated with a high prevalence of depression, which is influenced by personality traits and coping style. However, these psychological factors have not been well studied in individuals with T2DM. The association between coping behaviors and the reported levels of depressive symptoms was examined in individuals with T2DM.
The subjects were 435 T2DM patients (mean age 63.1 ± 12.6 years). Depressive status, personality traits and coping behaviors were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Brief Scale for Coping Profile (BSCP). Lifestyle factors and glycated hemoglobin A1c (HbA1c) levels in the patients were also included in the analyses.
Among the 435 subjects with T2DM, 130 (29.9%) exhibited possible depression, and 68 (15.6%) displayed probable depression. After adjustment for confounders, logistic and multiple regression analyses revealed that certain coping profile scores, such as Changing one's point of view, Emotional expression involving others and Avoidance and suppression, were consistently and significantly associated with the presence and severity of depression. No relationship was found between depression and HbA1c.
These findings indicate that Maladaptive emotion-focused coping strategies, such as Emotional expression involving others and Avoidance and suppression, are protective factors and that Adaptive emotion-focused coping, such as Changing one's point of view, is a risk factor for depression in T2DM patients. Psychological intervention focusing on the coping profile may reduce depressive symptoms. Additional studies are needed to examine the relationships between psychological factors and depressive symptoms using a longitudinal study design.
2型糖尿病(T2DM)与抑郁症的高患病率相关,抑郁症受人格特质和应对方式的影响。然而,这些心理因素在T2DM患者中尚未得到充分研究。本研究探讨了T2DM患者应对行为与报告的抑郁症状水平之间的关联。
研究对象为435例T2DM患者(平均年龄63.1±12.6岁)。使用流行病学研究中心抑郁量表(CES-D)和应对方式简表(BSCP)评估抑郁状态、人格特质和应对行为。患者的生活方式因素和糖化血红蛋白A1c(HbA1c)水平也纳入分析。
在435例T2DM患者中,130例(29.9%)表现出可能的抑郁,68例(15.6%)表现出可能的重度抑郁。在对混杂因素进行调整后,逻辑回归和多元回归分析显示,某些应对方式得分,如改变观点、与他人情感表达以及回避和压抑,与抑郁的存在和严重程度始终显著相关。未发现抑郁与HbA1c之间存在关联。
这些发现表明,适应不良的以情绪为中心的应对策略,如与他人情感表达以及回避和压抑,是保护因素,而适应良好的以情绪为中心的应对方式,如改变观点,是T2DM患者抑郁的危险因素。针对应对方式的心理干预可能会减轻抑郁症状。需要进一步研究采用纵向研究设计来探讨心理因素与抑郁症状之间的关系。