School of Psychology, University College Dublin, Dublin, Ireland.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
Diabetes Care. 2022 Aug 1;45(8):1715-1723. doi: 10.2337/dc21-2297.
In this study, we aimed to explore interactions between individual items that assess diabetes distress, depressive symptoms, and anxiety symptoms in a cohort of adults with type 2 diabetes using network analysis.
Participants (N = 1,796) were from the Montreal Evaluation of Diabetes Treatment (EDIT) study from Quebec, Canada. A network of diabetes distress was estimated using the 17 items of the Diabetes Distress Scale (DDS-17). A second network was estimated using the DDS-17 items, the nine items of the Patient Health Questionnaire (PHQ-9), and the seven items of the Generalized Anxiety Disorder Assessment (GAD-7). Network analysis was used to identify central items, clusters of items, and items that may act as bridges between diabetes distress, depressive symptoms, and anxiety symptoms.
Regimen-related and physician-related problems were among the most central (highly connected) and influential (most positive connections) in the diabetes distress network. The depressive symptom of failure was found to be a potential bridge between depression and diabetes distress, being highly connected to diabetes distress items. The anxiety symptoms of worrying too much, uncontrollable worry, and trouble relaxing were identified as bridges linking both anxiety and depressive items and anxiety and diabetes distress items, respectively.
Regimen-related and physician-related diabetes-specific problems may be important in contributing to the development and maintenance of diabetes distress. Feelings of failure and worry are potentially strong candidates for explaining comorbidity. These individual diabetes-specific problems and mental health symptoms could hold promise for targeted interventions for people with type 2 diabetes.
本研究旨在使用网络分析方法，探讨 2 型糖尿病患者群体中评估糖尿病困扰、抑郁症状和焦虑症状的个体项目之间的相互作用。
参与者（N=1796）来自加拿大魁北克省的蒙特利尔糖尿病治疗评估（EDIT）研究。使用糖尿病困扰量表（DDS-17）的 17 个项目来估计糖尿病困扰网络。使用 DDS-17 项目、患者健康问卷（PHQ-9）的 9 个项目和广泛性焦虑症评估（GAD-7）的 7 个项目来估计第二个网络。使用网络分析来识别中心项目、项目群和可能在糖尿病困扰、抑郁症状和焦虑症状之间起桥梁作用的项目。
与治疗方案相关和与医生相关的问题是糖尿病困扰网络中最核心（高度连接）和最具影响力（最积极连接）的项目之一。失败的抑郁症状被发现是抑郁和糖尿病困扰之间的潜在桥梁，与糖尿病困扰项目高度连接。过度担忧、无法控制的担忧和难以放松的焦虑症状被确定为连接焦虑和抑郁项目以及焦虑和糖尿病困扰项目的桥梁。
与治疗方案相关和与医生相关的糖尿病特定问题可能在导致糖尿病困扰的发展和维持中很重要。失败感和担忧感可能是解释共病的有力候选因素。这些个体的糖尿病特定问题和心理健康症状可能为 2 型糖尿病患者的针对性干预提供希望。
