Hsieh Hui-Min, Lin Ching-Hua, Weng Shih-Feng, Lin Pai-Cheng, Liu Tai-Ling, Huang Chun-Jen
Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
J Affect Disord. 2023 Apr 14;327:93-100. doi: 10.1016/j.jad.2023.02.011. Epub 2023 Feb 6.
Patients with either diabetes (DM) or depression (DP) are prone to developing other diseases and require more medical resources than do the general population. This study aimed to examine health-related quality of life, medical resource use, and physical function of patients with both diabetes mellitus and depression, and the magnitude of effects among patients with different combinations of comorbid diseases.
A retrospective cross-sectional study was conducted using the National Health and Nutrition Examination Survey data from 2009 to 2014. Total 16,159 patients were studied and classified into one of 4 groups: both DM and DP(DM+/DP+), DM+/without DP(DP-), without DM (DM-)/DP+, and DM-/DP-, according to the perceived score in Patient Health Questionnaire and diabetes questionnaire in NHANES. Health-related quality of life (HRQoL), medical resource use, and physical function were measured as outcomes of interests. Multivariate logistic regression models were used.
Compared with DM-/DP- patients, the DM+/DP+ (adjusted odds ratio [AOR]: 2.59; 95 % CI: 1.77-3.80) and DM-/DP+ (AOR: 2.44; 95 % CI: 1.94-3.06) had greater likely to have worse health. In addition, the DM+/DP+ (AOR: 5.40; 95 % CI: 1.30-22.41) and DM+/DP- (AOR: 2.49; 95 % CI: 1.91-3.25) were more likely to have medical visits, and worse physical function.
This study found that both depression and diabetes mellitus worsen HRQoL, increase medical resource use, and decrease physical function. Depression status should be considered by clinicians treating diabetes mellitus patients in order to improve their HRQoL, reduce medical resource use, and improve physical function.
糖尿病（DM）患者或抑郁症（DP）患者更容易患上其他疾病，并且比普通人群需要更多的医疗资源。本研究旨在调查糖尿病合并抑郁症患者的健康相关生活质量、医疗资源使用情况和身体功能，以及不同合并疾病组合患者之间的影响程度。
使用2009年至2014年的国家健康与营养检查调查数据进行回顾性横断面研究。共研究了16159名患者，并根据美国国家健康与营养检查调查（NHANES）中患者健康问卷和糖尿病问卷的感知得分，将其分为4组之一：糖尿病合并抑郁症（DM+/DP+）、糖尿病合并无抑郁症（DP-）、无糖尿病（DM-）合并抑郁症（DP+）和无糖尿病合并无抑郁症（DM-/DP-）。将健康相关生活质量（HRQoL）、医疗资源使用情况和身体功能作为感兴趣的结果进行测量。使用多变量逻辑回归模型。
与DM-/DP-患者相比，DM+/DP+（调整优势比[AOR]：2.59；95%置信区间[CI]：1.77-3.80）和DM-/DP+（AOR：2.44；95%CI：1.94-3.06）患者健康状况较差的可能性更大。此外，DM+/DP+（AOR：5.40；95%CI：1.30-22.41）和DM+/DP-（AOR：2.49；95%CI：1.91-3.25）患者更有可能就医，且身体功能较差。
本研究发现，抑郁症和糖尿病都会恶化健康相关生活质量、增加医疗资源使用并降低身体功能。治疗糖尿病患者的临床医生应考虑患者的抑郁状态，以改善其健康相关生活质量、减少医疗资源使用并改善身体功能。
