Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand.
Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand.
Prim Care Diabetes. 2020 Dec;14(6):703-708. doi: 10.1016/j.pcd.2020.07.004. Epub 2020 Jul 25.
Diabetes is associated with depression, anxiety and psychosis via complex bidirectional relationships that are affected by factors such as the type of diabetes and socioeconomic status. The aim of the study was to estimate the prevalence of mental health conditions in patients with diabetes in a New Zealand primary care population using proxy medication dispensing data.
Primary care data (July 1 2016 - June 30, 2018) was collected from the Patient Management System of 15 different general practices, and was linked via National Health Index number to clinical records at the Waikato District Health Board and the New Zealand Ministry of Health Pharmaceutical database.
A total of 3978 patients with diabetes were identified from an enrolled patient population of 74,250. Of these, 18.0% of patients with diabetes were dispensed an antidepressant, anxiolytic, or antipsychotic. These medications were prescribed more in New Zealand Europeans (20.9% versus 13.9% in Māori), women, type 2 diabetes, those on insulin, and those with a higher BMI (all P<0.001).
Approximately one fifth of patients with diabetes in primary care have mental health disorders. Appropriate management requires concomitant treatment of both the diabetes and the mental health disorder to improve patient outcomes.
糖尿病通过复杂的双向关系与抑郁、焦虑和精神病相关，这些关系受到糖尿病类型和社会经济地位等因素的影响。本研究旨在使用代理药物配药数据估计新西兰初级保健人群中糖尿病患者的心理健康状况患病率。
从 15 家不同的全科诊所的患者管理系统中收集了 2016 年 7 月 1 日至 2018 年 6 月 30 日的初级保健数据，并通过国家健康指数号与怀卡托地区卫生局和新西兰卫生部药物数据库的临床记录进行了关联。
从登记患者人群 74250 人中确定了 3978 名患有糖尿病的患者。其中，18.0%的糖尿病患者配了抗抑郁药、抗焦虑药或抗精神病药。这些药物在新西兰欧洲人（毛利人 13.9%，新西兰欧洲人 20.9%）、女性、2 型糖尿病、使用胰岛素和 BMI 较高的患者中更为常见（均 P<0.001）。
初级保健中约有五分之一的糖尿病患者患有精神健康障碍。适当的管理需要同时治疗糖尿病和精神健康障碍，以改善患者的预后。
