Wang Qianjin, Li Yifan, Ren Honghong, Huang Qiuping, Wang Xuyi, Zhou Yanan, Wu Qiuxia, Liu Yueheng, Li Manyun, Wang Yunfei, Liu Tieqiao, Zhang Xiangyang
Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
J Affect Disord. 2023 Mar 1;324:341-348. doi: 10.1016/j.jad.2022.12.096. Epub 2022 Dec 28.
Both major depressive disorder (MDD) and impaired fasting glucose (IFG) are associated with metabolic abnormalities and anxiety, but few studies have investigated the relationship between abnormal metabolism and anxiety in first-episode and drug-naïve (FEDN) MDD patients with IFG. This study investigated the psychological status, metabolic properties, the prevalence and influencing factors of anxiety symptoms in the FEDN MDD patients with IFG.
A total of 1718 FEDN MDD outpatients were recruited. Sociodemographic and suicide data were collected for each participant. The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) were used to assess patients' clinical symptoms. Fasting blood glucose, lipids, body mass index (BMI), and thyroid function-related indicators were also measured.
FEDN MDD patients with IFG (IFG group) had higher psychotic symptoms, suicide attempts, HAMD score, and HAMA score than FEDN MDD patients without IFG (NIFG group). There were also significant differences in blood lipids, BMI, and thyroid function indicators between the two groups. The prevalence of anxiety symptoms in the IFG group was 20.9 %, which was significantly higher than that in the NIFG group (10.4 %). Furthermore, anxiety symptoms were significantly associated with female, marital status, psychotic symptoms, suicide attempts, and low high-density lipoprotein (HDL-C).
FEDN MDD patients with anxiety who have IFG are more likely to have problems with thyroid function, lipid metabolism, psychotic symptoms and suicide attempts, especially in female patients. Prevention of these problems should be enhanced when treating such patients.
重度抑郁症（MDD）和空腹血糖受损（IFG）均与代谢异常及焦虑相关，但很少有研究调查首发且未用药的MDD合并IFG患者中代谢异常与焦虑之间的关系。本研究调查了首发且未用药的MDD合并IFG患者的心理状态、代谢特征、焦虑症状的患病率及影响因素。
共招募了1718例首发且未用药的MDD门诊患者。收集每位参与者的社会人口学和自杀数据。采用阳性和阴性症状量表（PANSS）、汉密尔顿抑郁评定量表（HAMD）和汉密尔顿焦虑评定量表（HAMA）评估患者的临床症状。还测量了空腹血糖、血脂、体重指数（BMI）和甲状腺功能相关指标。
合并IFG的首发且未用药的MDD患者（IFG组）比未合并IFG的首发且未用药的MDD患者（NIFG组）有更高的精神病性症状、自杀企图、HAMD评分和HAMA评分。两组之间的血脂、BMI和甲状腺功能指标也存在显著差异。IFG组焦虑症状的患病率为20.9%，显著高于NIFG组（10.4%）。此外，焦虑症状与女性、婚姻状况、精神病性症状、自杀企图及低高密度脂蛋白（HDL-C）显著相关。
合并IFG且有焦虑症状的首发且未用药的MDD患者更易出现甲状腺功能、脂质代谢、精神病性症状及自杀企图方面的问题，尤其是女性患者。治疗此类患者时应加强对这些问题的预防。
