School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador.
Medicine (Baltimore). 2022 Sep 30;101(39):e30697. doi: 10.1097/MD.0000000000030697.
Type II diabetes mellitus (DM2) is a worldwide disease with an important economic and health impact. Currently, depression, anxiety and stress are common disorders among diabetic populations but their respective prevalence may well be underestimated. So far, Latin American countries have only reported limited information about the impact of mental diseases on DM2 outpatients. The objective of this study was to evaluate the prevalence and risk factors related to depression, anxiety, and stress among ambulatory DM2 populations from two third-level hospitals in Quito, Ecuador. A cross-sectional study based on a random sample was carried out in two hospitals. Patients were evaluated by the 21-item Depression, Anxiety and Stress Scale (DASS-21). In addition, a validated survey was used to grade socioeconomic, demographic, clinical, and comorbidity variables. Descriptive statistics and multiple logistic regression were used to analyze the data. Statistical analysis was performed by SPSS (version 22.0). STROBE guidelines were used for reporting this trial. A total of 208 adult patients with DM2 were included (women 58%; men 42%). The prevalence of depression, anxiety and stress was 31.7% (95% CI, 25.5-38.5%), 33.7% (95% CI, 27.3-40.5%), and 25.0% (95% CI, 19.3-31.5%), respectively. Male gender was associated with a decreased risk for depression (OR 0.39 [95% CI, 0.18-0.81]; P = .01), anxiety (OR 0.31 [95% CI, 0.16-0.65]; P = .002), and stress (OR 0.35 [95% CI, 0.15-0.77]; P = .009). A higher level of education was associated with low risk for depression (OR 0.23 [95% CI, 0.11-0.46]; P < .001), anxiety (OR 0.47 [95% CI, 0.25-0.90]; P = .02), and stress (OR 0.24 [95% CI, 0.12-0.49]; P = .001). In contrast, patients with DM2 complications were more likely to have depression (OR 2.96 [95% CI, 1.32-6.63]; P = .008) and anxiety (OR 2.56 [95% CI, 1.20-5.48]; P = .01). Finally, an income higher than the basic salary reduced the risk of depression alone (OR 0.39 [95% CI, 0.16-0.91]; P = .03). In conclusion, a high prevalence rate of depression, anxiety, and stress was found in the DM2 outpatient population. Thus, more tailored care surveillance for DM2 patients is needed considering the bio-psycho-social environment to provide an integral health management.
2 型糖尿病（DM2）是一种全球性疾病，对经济和健康有重大影响。目前，糖尿病患者中常见的疾病是抑郁、焦虑和压力，但它们的患病率可能被低估了。到目前为止，拉丁美洲国家仅报告了有限的关于精神疾病对厄瓜多尔基多两家三级医院的 DM2 门诊患者的影响的信息。本研究的目的是评估在厄瓜多尔基多两家三级医院的 DM2 门诊人群中抑郁、焦虑和压力的患病率和相关危险因素。一项基于随机样本的横断面研究在两家医院进行。采用 21 项抑郁、焦虑和压力量表（DASS-21）对患者进行评估。此外，还使用经过验证的调查问卷对社会经济、人口统计学、临床和合并症变量进行分级。采用描述性统计和多因素逻辑回归分析数据。统计分析采用 SPSS（版本 22.0）进行。STROBE 指南用于报告这项试验。共纳入 208 例成年 DM2 患者（女性 58%；男性 42%）。抑郁、焦虑和压力的患病率分别为 31.7%（95%CI，25.5-38.5%）、33.7%（95%CI，27.3-40.5%）和 25.0%（95%CI，19.3-31.5%）。男性与抑郁（OR 0.39 [95%CI，0.18-0.81]；P =.01）、焦虑（OR 0.31 [95%CI，0.16-0.65]；P =.002）和压力（OR 0.35 [95%CI，0.15-0.77]；P =.009）的低风险相关。较高的教育水平与抑郁（OR 0.23 [95%CI，0.11-0.46]；P <.001）、焦虑（OR 0.47 [95%CI，0.25-0.90]；P =.02）和压力（OR 0.24 [95%CI，0.12-0.49]；P =.001）的低风险相关。相比之下，有 DM2 并发症的患者更有可能出现抑郁（OR 2.96 [95%CI，1.32-6.63]；P =.008）和焦虑（OR 2.56 [95%CI，1.20-5.48]；P =.01）。最后，收入高于基本工资可降低抑郁的风险（OR 0.39 [95%CI，0.16-0.91]；P =.03）。总之，DM2 门诊人群中存在较高的抑郁、焦虑和压力患病率。因此，需要对 DM2 患者进行更有针对性的护理监测，考虑到生物-心理-社会环境，提供全面的健康管理。
