Gregory Jonathan M, Rosenblat Joshua D, McIntyre Roger S
Dr. Gregory is with the Department of Psychiatry, Western University, London, Ontario, Canada. Dr. Rosenblat and Dr. McIntyre are with the Department of Pharmacology and the Mood Disorder Psychopharmacology Unit, University Health Network, and the Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Send correspondence to Dr. McIntyre (e-mail:
Focus (Am Psychiatr Publ). 2016 Apr;14(2):184-193. doi: 10.1176/appi.focus.20150040. Epub 2016 Apr 7.
Depression and diabetes are common, chronic, and frequently comorbid diseases that contribute substantially to global disability and mortality. Their relationship is bidirectional: depression increases the risk of developing type 2 diabetes mellitus (T2DM), and diabetes increases the risk of depression. Unhealthy lifestyles and poor self-care by patients with depression contribute to the increased T2DM risk. The psychosocial burden of a diabetes diagnosis and its eventual complications predispose diabetic patients to depressive symptoms. Neuroendocrine alterations and inflammation may underlie the increased risk of T2DM in depression but are also proposed as common causative factors for both illnesses. Screening for depression is essential in T2DM, and vice versa. Selective serotonin reuptake inhibitors effectively treat depression of patients with diabetes and positively influence glycemic control. Psychological interventions are effective for depressive symptoms, but their effect on glycemic control varies. Novel depression interventions targeting inflammation or insulin resistance underscore the common biological underpinnings of mood and metabolism.
抑郁症和糖尿病是常见的慢性疾病，且常常合并出现，它们是导致全球残疾和死亡的主要因素。它们之间的关系是双向的：抑郁症会增加患2型糖尿病（T2DM）的风险，而糖尿病会增加患抑郁症的风险。抑郁症患者不健康的生活方式和自我护理不佳会导致T2DM风险增加。糖尿病诊断及其最终并发症带来的心理社会负担使糖尿病患者易出现抑郁症状。神经内分泌改变和炎症可能是抑郁症患者患T2DM风险增加的基础，但也被认为是这两种疾病的共同致病因素。在T2DM患者中筛查抑郁症至关重要，反之亦然。选择性5-羟色胺再摄取抑制剂可有效治疗糖尿病患者的抑郁症，并对血糖控制产生积极影响。心理干预对抑郁症状有效，但其对血糖控制的影响各不相同。针对炎症或胰岛素抵抗的新型抑郁症干预措施强调了情绪和代谢的共同生物学基础。
