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糖尿病患者在急诊就诊后入住糖尿病诊所时的精神状态:SCL - 90量表的应用

The Mental Status in Patients with Diabetes Mellitus Admitted to a Diabetes Clinic After Presenting in the Emergency Room: The Application of the SCL-90 Scale.

作者信息

Albai Oana, Frandes Mirela, Timar Romulus, Timar Bogdan, Anghel Teodora, Avram Vlad Florian, Sima Alexandra

机构信息

Department of Internal Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.

Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.

出版信息

Diabetes Metab Syndr Obes. 2021 Apr 28;14:1833-1840. doi: 10.2147/DMSO.S304904. eCollection 2021.

Abstract

BACKGROUND

Diabetes mellitus (DM) is one of the most serious public health problems, involving increasing costs worldwide. The mental state of a person with DM is varied and ever-changing, such as stress, the pressure to always do everything by the book, sadness, anger, and even denial of the disease, all these are feelings patients with DM will experience throughout their life.

AIM

The aim of our study was to assess the presence of mental and psychiatric disorders (anxiety, depressive states, paranoid ideation, phobia, obsessive-compulsive disorder) in a group of patients with DM after hospitalization in the Clinic for Diabetes, Nutrition, and Metabolic Diseases, for various exacerbations of the underlying condition, looking for possible correlations with other cardiovascular risk factors.

PATIENTS AND METHODS

Clinical and biological parameters, the presence of acute and chronic complications of the diabetic patients have been evaluated. To assess mental health, the symptom checklist (SCL)-90 questionnaire was conducted for all admitted patients.

RESULTS

We observed that the number of patients with obsessive-compulsive disorders was relatively high (23.3%), while depression was present in 17.1% of the patients. Also, 10.6% of patients had hostility and 15.6% had delusional ideation. The presence of psychiatric disorders was associated with a higher age (62 vs. 46.5 years; <0.001), a longer diabetes duration (11 vs. 9 years; <0.001), higher fasting glycemia (188 vs. 132 mg/dL; 0.001) and postprandial glycemia (212 vs. 152 mg/dL; 0.001), and triglycerides (125 vs. 110 mg/dL; 0.001). Patients with altered mental status have shown statistically significantly more altered clinical and biological parameters compared to those without these mental disorders.

CONCLUSION

Patients with DM represent a psychologically vulnerable population, which is why they should undergo early and regular screening for both psychological and psychiatric conditions, especially at admission.

摘要

背景

糖尿病(DM)是最严重的公共卫生问题之一,在全球范围内导致成本不断增加。糖尿病患者的心理状态多种多样且不断变化,如压力、凡事都要循规蹈矩的压力、悲伤、愤怒,甚至对疾病的否认,所有这些都是糖尿病患者一生中会经历的感受。

目的

我们研究的目的是评估在糖尿病、营养与代谢疾病诊所因基础疾病各种加重情况住院后的一组糖尿病患者中精神和精神障碍(焦虑、抑郁状态、偏执观念、恐惧症、强迫症)的存在情况,寻找与其他心血管危险因素的可能关联。

患者与方法

评估了糖尿病患者的临床和生物学参数、急性和慢性并发症的存在情况。为评估心理健康状况,对所有入院患者进行了症状自评量表(SCL)-90问卷调查。

结果

我们观察到强迫症患者数量相对较多(23.3%),而17.1%的患者存在抑郁。此外,10.6%的患者有敌意,15.6%的患者有妄想观念。精神障碍的存在与较高年龄(62岁对46.5岁;<0.001)、较长糖尿病病程(11年对9年;<0.001)、较高空腹血糖(188mg/dL对132mg/dL;0.001)和餐后血糖(212mg/dL对152mg/dL;0.001)以及甘油三酯(125mg/dL对110mg/dL;0.001)相关。与没有这些精神障碍的患者相比,精神状态改变的患者在临床和生物学参数方面的改变在统计学上更显著。

结论

糖尿病患者是心理上易受伤害的人群,这就是为什么他们应该接受早期和定期的心理和精神状况筛查,尤其是在入院时。

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