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沙特阿拉伯塔伊夫地区糖尿病患者的抑郁症状:患病率、相关因素及调节作用

Depressive symptoms in diabetic patients; prevalence, correlates, and moderating effect in Taif, Saudi Arabia.

作者信息

Alosaimi Ameera Mishal, Alsulaimani Nada Hamed, Alotaibi Wejdan

机构信息

Department of Family Medicine, Prince Mansour Military Hospital, Taif, Saudi Arabia.

Department of Family Medicine, Taif University School of Medicine, Taif, Saudi Arabia.

出版信息

J Family Med Prim Care. 2022 Dec;11(12):7671-7679. doi: 10.4103/jfmpc.jfmpc_1193_22. Epub 2023 Jan 17.

Abstract

BACKGROUND

Diabetes is associated with a range of psychosocial stressors that could lead to considerable distress and increased risk of depressive symptoms. There is a pressing need to understand the underpinnings of diabetes-related distress and how it evolves in connection with depressive moods, and fears related to hypoglycaemia. Our current study attempts to fill this knowledge gap and further explore the interconnections between distress, fear, and depression among Saudi diabetic patients.

METHODS

Descriptive questionnaire-based cross-sectional study of type II diabetes patients in a specialist diabetes clinic in Taif, Saudi Arabia. We carried out Poisson regression modelling to evaluate the correlates of depressive and distress symptoms.

RESULTS

The study included ( = 365) patients living with type II diabetes. Cronbach's alpha for the DDS-17 was 0.93, and for HABS was 0.84, indicative of excellent internal consistency. Diabetes-related distress affected ( = 114, 22.8%) patients, whereas depressive symptoms affected ( = 190, 52.1%) patients. The mean HABS score was 32.7 points (out of 70 points) (SD = 9.8 points). High physical activity levels were found only in ( = 23, 6.3%) patients and moderate physical activity in ( = 65, 17.8%), whereas patients with low physical activity were ( = 277, 75.9%). Diabetes-related distress was associated with increased HbA1c, presence of eye disease, comorbid mental illness, heart disease, stroke, and low physical activity levels. Depressive symptoms were associated with increased HbA1c, longer diabetes duration, presence of eye disease, comorbid mental illness, comorbid neuropathy, heart disease, and low physical activity levels.

CONCLUSIONS

Distress and depression levels are worryingly higher than previous estimates from Saudi Arabia among patients with type II diabetes, indicative of an upward trend and/or a pandemic-related jump. One significant finding from our results is the substantial effect of glycaemic control on increased distress, and depression among our type II diabetes patients. This interaction is likely due to effects on self-care and medication adherence. We also confirmed the association between depressive symptoms and the duration of diabetes. Our results indicated a connection between comorbid medical illness with depressive and distress symptoms.

摘要

背景

糖尿病与一系列心理社会应激源相关,这些应激源可能导致相当大的痛苦,并增加抑郁症状的风险。迫切需要了解糖尿病相关痛苦的根源,以及它如何与抑郁情绪和低血糖恐惧相关联并演变。我们目前的研究试图填补这一知识空白,并进一步探讨沙特糖尿病患者痛苦、恐惧和抑郁之间的相互联系。

方法

在沙特阿拉伯塔伊夫的一家专科糖尿病诊所,对II型糖尿病患者进行基于描述性问卷的横断面研究。我们进行泊松回归建模以评估抑郁和痛苦症状的相关因素。

结果

该研究纳入了365名II型糖尿病患者。DDS - 17的克朗巴哈系数为0.93,HABS的克朗巴哈系数为0.84,表明内部一致性极佳。糖尿病相关痛苦影响了114名(22.8%)患者,而抑郁症状影响了190名(52.1%)患者。HABS平均得分为32.7分(满分70分)(标准差 = 9.8分)。只有23名(6.3%)患者身体活动水平高,65名(17.8%)患者身体活动水平中等,而身体活动水平低的患者有277名(75.9%)。糖尿病相关痛苦与糖化血红蛋白升高、眼部疾病、合并精神疾病、心脏病、中风以及低身体活动水平相关。抑郁症状与糖化血红蛋白升高、糖尿病病程延长、眼部疾病、合并精神疾病、合并神经病变、心脏病以及低身体活动水平相关。

结论

在II型糖尿病患者中,痛苦和抑郁水平高于沙特阿拉伯先前的估计,令人担忧,这表明有上升趋势和/或与大流行相关的跃升。我们研究结果的一个重要发现是血糖控制对II型糖尿病患者痛苦增加和抑郁有重大影响。这种相互作用可能是由于对自我护理和药物依从性的影响。我们还证实了抑郁症状与糖尿病病程之间的关联。我们的结果表明合并内科疾病与抑郁和痛苦症状之间存在联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f243/10041008/641146e90238/JFMPC-11-7671-g001.jpg

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