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探索有饮食行为障碍风险的1型糖尿病儿童的情绪调节障碍特征及共病精神障碍。

Exploring emotional dysregulation characteristics and comorbid psychiatric disorders in type 1 diabetic children with disordered eating behavior risk.

作者信息

Yilmaz Kafali Helin, Atik Altinok Yasemin, Ozbaran Burcu, Ozen Samim, Kose Sezen, Tahillioglu Akin, Darcan Sukran, Goksen Damla

机构信息

Ankara City Hospital, Department of Child and Adolescent Psychiatry, Ankara, Turkey.

Ege University School of Medicine, Department of Child Endocrinology, Izmir, Turkey.

出版信息

J Psychosom Res. 2020 Feb 11;131:109960. doi: 10.1016/j.jpsychores.2020.109960.

Abstract

OBJECTIVE

To investigate emotional dysregulation and psychiatric comorbidities associated with DEB-risk in children with type 1 diabetes mellitus (T1DM).

METHODS

A total of 75 children with T1DM aged between 8 and 19 were evaluated by K-SADS-PL to assess psychiatric diagnosis. DEB-risk was evaluated via Diabetes Eating Problem Survey-Revised (DEPS-R). Besides, all participants completed the Childhood Depression Inventory (CDI), Difficulties in Emotion Regulation Scale (DERS), and The State-Trait Anxiety Inventory (STAI).

RESULTS

DEPS-R-positive (≥20) was detected in 28% of the participants. The only diagnostic difference was a significantly higher frequency of ED in DEPS-R-positive than DEPS-R-negative (OR = 8.5, CI = 1.94-37.1, p = .004). DEPS-R-positive cases had significantly higher scores of the CDI, STAI, DERS, and the subscales of Goals, Impulse, and Strategies of DERS (CDI U = 266.500, p = .001; STAI U = 288.500,p = .001; DERS U = 229.000, p = .001, Goals U = 283.500, p = .008, Impulse U = 274.000, p = .005, Strategies U = 281.500, p = .007). In stepwise linear regression analysis, STAI-state and DERS scores significantly determined DEB-risk (STAI: β = 0.363, t(60) = 2.33, p = .02, DERS: β = 0.240, t(60) = 4.14, p < .001).

CONCLUSION

This cross-sectional study showed that DEPS-R-positive cases have an 8.5-fold increased risk for ED. DEPS-R-positive ones have difficulties in regulating their emotions and they are incapable of accessing emotion regulation strategies, engaging in goal-directed behavior while under difficult emotions, and impulse control. It can be beneficial for child psychiatrists to screen first for ED in DEPS-R-positive cases who are referred by child endocrinologist. They should also take into consideration anxiety levels and problems in emotion dysregulation in the DEPS-R-positive cases.

摘要

目的

探讨1型糖尿病(T1DM)患儿中与饮食失调风险(DEB-risk)相关的情绪调节障碍及精神共病情况。

方法

采用儿童版情感障碍和精神分裂症问卷(K-SADS-PL)对75名年龄在8至19岁的T1DM患儿进行评估以确定精神疾病诊断。通过修订版糖尿病饮食问题调查(DEPS-R)评估DEB风险。此外,所有参与者均完成儿童抑郁量表(CDI)、情绪调节困难量表(DERS)和状态-特质焦虑量表(STAI)。

结果

28%的参与者DEPS-R呈阳性(≥20)。唯一的诊断差异是DEPS-R阳性组的饮食失调(ED)发生率显著高于DEPS-R阴性组(OR = 8.5,CI = 1.94 - 37.1,p = 0.004)。DEPS-R阳性病例的CDI、STAI、DERS以及DERS的目标、冲动和策略子量表得分显著更高(CDI U = 266.500,p = 0.001;STAI U = 288.500,p = 0.001;DERS U = 229.000,p = 0.001,目标U = 283.500,p = 0.008,冲动U = 274.000,p = 0.005,策略U = 281.500,p = 0.007)。在逐步线性回归分析中,STAI状态量表得分和DERS得分显著决定了DEB风险(STAI:β = 0.363,t(60) = 2.33,p = 0.02;DERS:β = 0.240,t(60) = 4.14,p < 0.001)。

结论

这项横断面研究表明,DEPS-R阳性病例患ED的风险增加8.5倍。DEPS-R阳性者在情绪调节方面存在困难,在情绪困扰时无法运用情绪调节策略、进行目标导向行为和控制冲动。对于儿童精神科医生而言,对儿童内分泌科转诊的DEPS-R阳性病例首先筛查ED可能有益。他们还应考虑DEPS-R阳性病例的焦虑水平和情绪调节障碍问题。

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