Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.
Department of Internal Medicine, Shirakawa Kosei General Hospital, Shirakawa, Japan.
BMJ Open Diabetes Res Care. 2021 Sep;9(1). doi: 10.1136/bmjdrc-2020-002007.
A triple disaster struck eastern Japan in March 2011. We investigated the psychological distress and post-traumatic stress disorder (PTSD) symptoms caused by the disaster in people without or with diabetes mellitus.
This cross-sectional analysis examined the 16 097 evacuees (1820 (11.3%) with and 14 277 (88.7%) without diabetes mellitus) included in the Fukushima Health Management Survey. Non-specific mental health distress was assessed using the Kessler-6 Scale, and traumatic symptoms were evaluated using the PTSD Checklist. Logistic regression analyses were used to estimate the OR and 95% CI associated with symptoms, adjusted for diabetes-related and disaster-related factors.
In the age-adjusted and sex-adjusted logistic models, suboptimal diabetic control (hemoglobin A1c (HbA1c) ≥7%) was associated with both psychological distress and possible PTSD. In the same models, current smoking, evacuation, and sleep dissatisfaction were associated with psychological distress and possible PTSD. In the multivariate-adjusted logistic models, HbA1c ≥7% was associated with psychological distress, independent of job change, evacuation, or sleep dissatisfaction.
After the triple disaster, non-specific mental health distress was associated with suboptimal diabetic control. Thus, patients with diabetes, especially those with suboptimal diabetic control, may be vulnerable to postdisaster psychological burden.
2011 年 3 月,日本东部遭遇三重灾难。我们调查了没有或患有糖尿病的人因这场灾难而产生的心理困扰和创伤后应激障碍(PTSD)症状。
本横断面分析检查了福岛健康管理调查中纳入的 16097 名避难者(1820 名(11.3%)患有糖尿病和 14277 名(88.7%)无糖尿病)。使用 Kessler-6 量表评估非特异性心理健康困扰,使用 PTSD 清单评估创伤后症状。使用逻辑回归分析估计与症状相关的 OR 和 95%CI,调整与糖尿病相关和与灾难相关的因素。
在年龄调整和性别调整的逻辑模型中,血糖控制不佳(糖化血红蛋白(HbA1c)≥7%)与心理困扰和可能的 PTSD 均相关。在相同模型中,当前吸烟、疏散和睡眠不满与心理困扰和可能的 PTSD 相关。在多变量调整的逻辑模型中,HbA1c≥7%与心理困扰相关,与工作变动、疏散或睡眠不满无关。
三重灾难后,非特异性心理健康困扰与血糖控制不佳有关。因此,糖尿病患者,尤其是血糖控制不佳的患者,可能容易受到灾后心理负担的影响。