Cattedra di Psichiatria, Dipartimento di Medicina dei Sistemi, University of Rome Tor Vergata, Rome, Italy.
Unità Piede Diabetico, Dipartimento di Medicina Interna, University of Rome Tor Vergata, Rome, Italy.
Riv Psichiatr. 2020 Nov-Dec;55(6):349-354. doi: 10.1708/3503.34893.
Type 2 diabetes mellitus (T2DM) is a complex and demanding chronic condition resulting from the body's inability to adequately produce and or effectively utilize insulin. A wide variety of lifestyle factors are of great importance to the development of T2DM, such as sedentary lifestyle, obesity, physical inactivity, smoking and alcohol consumption. An emerging body of literature suggests that stress and traumatic experiences have a role in the aetiology of T2DM.
We recruited a sample of 52 patients with a diagnosis of T2DM and a control group of 48 subjects. Using the Traumatic Experience Checklist (TEC), the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), and the Connor-Davidson Resilience Scale (CD-RISC 25), we investigated the presence of history of traumatic experiences and of childhood experience of neglect and abuse.
We found that patients with a diagnosis of T2DM have a higher number of traumatic experiences in their personal history, when compared to the control group.
Traumatic experiences or sustained stress exposure may contribute to the onset of T2DM. Neuro-inflammatory and psychoanalytic factors will be discussed to explain such association.
We conclude that factors that determine high levels of resiliency can have a protective effect against the development of T2DM while stress and the consequent inflammation can contribute to the development of depression and T2DM. These biological features are analyzed in the psychoanalytical context of theories from Freud, Mahler, and Kohut.
2 型糖尿病（T2DM）是一种复杂且要求苛刻的慢性疾病，源于机体无法充分产生和/或有效利用胰岛素。大量生活方式因素对 T2DM 的发生具有重要意义，例如久坐不动的生活方式、肥胖、身体活动不足、吸烟和饮酒。越来越多的文献表明，压力和创伤经历在 T2DM 的发病机制中起作用。
我们招募了 52 名 T2DM 患者和 48 名对照组受试者。使用创伤经历检查表（TEC）、儿童关怀和虐待问卷（CECA-Q）和 Connor-Davidson 韧性量表（CD-RISC 25），我们调查了创伤经历和儿童期忽视和虐待经历的存在情况。
与对照组相比，我们发现被诊断患有 T2DM 的患者在个人病史中有更多的创伤经历。
创伤经历或持续的压力暴露可能导致 T2DM 的发生。神经炎症和精神分析因素将被讨论以解释这种关联。
我们得出结论，决定高韧性水平的因素可能对 T2DM 的发生具有保护作用，而压力和随之而来的炎症可能导致抑郁和 T2DM 的发生。这些生物学特征在弗洛伊德、马勒和科胡特的精神分析理论背景下进行了分析。
