Department of Clinical and Experimental Medicine, University of Pisa, Pisa.
Department of Psychiatry, Local Health Unit n. 2, Terni.
Int Clin Psychopharmacol. 2024 Sep 1;39(5):294-304. doi: 10.1097/YIC.0000000000000515. Epub 2023 Oct 21.
The association between mood disorders, especially bipolar disorder (BD), and metabolic disorders, is long known. However, to which extent metabolic disorders affect the course of mood disorders in late life is still open to inquiring. To assess the impact of type 2 diabetes mellitus (T2DM) on late-life mood disorders a retrospective chart review was performed. Elderly depressive patients (≥ 65 years) diagnosed with Major Depressive Disorder (N = 57) or BD (N = 43) and followed up for at least 18 months were included and subdivided according to the presence of T2DM comorbidity. Vascular encephalopathy (39.1% vs. 15.6%, P = 0.021) and neurocognitive disorders (21.7% vs. 5.2%, P = 0.028), were more frequently reported in patients with T2DM than in those without. Patients with T2DM showed a greater percentage of follow-up time in manic episodes (r = -0.23, P = 0.020) and a higher rate of manic episode(s) during follow-up (21.7% vs. 5.2%, P = 0.028) than those without. When restricting longitudinal analyses to patients with bipolar spectrum disorders, results were confirmed. In line with the well-known connection between BD and metabolic disorders, our data support an association between T2DM and unfavorable course of illness in the elderly with BD.
心境障碍(尤其是双相障碍)与代谢紊乱之间的关联早已为人所知。然而,代谢紊乱在多大程度上影响老年心境障碍的病程仍有待探究。为了评估 2 型糖尿病(T2DM)对老年心境障碍的影响,我们进行了一项回顾性图表审查。诊断为重度抑郁症(N=57)或双相障碍(N=43)且至少随访 18 个月的老年抑郁患者符合入组标准,并根据是否合并 T2DM 进行了细分。患有 T2DM 的患者比未患有 T2DM 的患者更容易出现血管性脑病(39.1% vs. 15.6%,P=0.021)和神经认知障碍(21.7% vs. 5.2%,P=0.028)。与未合并 T2DM 的患者相比,合并 T2DM 的患者在随访期间有更长的躁狂发作时间(r=-0.23,P=0.020),且躁狂发作(s)的发生率更高(21.7% vs. 5.2%,P=0.028)。当将纵向分析限制在双相谱系障碍患者中时,结果得到了证实。与 BD 和代谢紊乱之间的已知关联一致,我们的数据支持 T2DM 与老年 BD 患者不良病程之间的关联。