Department of Psychology, Islamic Azad University, Rodhen Branch, Rudehen, Iran.
Islamic Azad University, Shahrood Branch, Shahrud, Iran.
Acta Diabetol. 2024 May;61(5):609-622. doi: 10.1007/s00592-024-02234-z. Epub 2024 Feb 16.
The main aim of this study was to assess the prevalence of suicidal ideation and previous suicide attempts among Iranian patients diagnosed with Type-1 diabetes (T1D) and Type-2 diabetes (T2D). Additionally, the study sought to estimate the network structure of depressive symptoms and cognitive functions.
1073 patients participated in the current study. We used Patient Health Questionnaire-9 (PHQ-9), Ask Suicide-Screening Questionnaire, diabetes-related factors, and a battery of cognitive functions tasks to estimate network structures. Also, suicidal ideations and suicide attempts prevalence have been estimated. Statistical analyses were performed using R-studio software, including mixed-graphical models (MGMs) for undirected effects and Directed Acyclic Graphs (DAGs) for directed effects.
The prevalence of suicidal ideation was 29.97% in T1D and 26.81% in T2D (p < 0.05). The history of suicide attempts was higher in T1D (10.78%) compared to T2D (8.36%) (p < 0.01). In the MRF networks for T1D, suicidal ideation was directly linked to 'feeling guilt (PHQ.6)', 'Suicide (PHQ.9)', HbA1c, and FBS, while the Inhibition node was directly related to suicidal ideation. The DAGs suggested connections between 'depression', HbA1c, and 'inhibition' with suicidal ideation, along with a link between the current family history of suicide attempts and the patient's history of suicide attempts. For T2D, the MRF networks indicated direct links between suicidal ideation and 'anhedonia (PHQ.1)', 'suicide (PHQ.9)', age, being female, and BMI, with inhibition also being directly related to suicidal ideation. The DAGs revealed connections between 'depression', age, and 'inhibition' with suicidal ideation, as well as links between being female or single/divorced and the patient's history of suicide attempts.
The findings suggest that suicide ideation is highly prevalent in patients with diabetes, and these symptoms should be carefully monitored in these patients.
本研究的主要目的是评估伊朗 1 型糖尿病（T1D）和 2 型糖尿病（T2D）患者自杀意念和既往自杀企图的发生率。此外，本研究还旨在估计抑郁症状和认知功能的网络结构。
1073 名患者参与了本研究。我们使用患者健康问卷-9（PHQ-9）、自杀筛查问卷、糖尿病相关因素和一系列认知功能任务来估计网络结构。此外，还估计了自杀意念和自杀企图的发生率。统计分析使用 R-studio 软件进行，包括无向效应的混合图形模型（MGM）和有向效应的有向无环图（DAG）。
T1D 患者自杀意念的发生率为 29.97%，T2D 患者为 26.81%（p<0.05）。T1D 患者自杀企图的历史发生率高于 T2D（10.78%比 8.36%）（p<0.01）。在 T1D 的 MRF 网络中，自杀意念与“感到内疚（PHQ.6）”、“自杀（PHQ.9）”、HbA1c 和 FBS 直接相关，而抑制节点与自杀意念直接相关。DAG 表明“抑郁”、HbA1c 和“抑制”与自杀意念之间存在联系，以及当前自杀企图家族史与患者自杀企图史之间存在联系。对于 T2D，MRF 网络表明自杀意念与“快感缺失（PHQ.1）”、“自杀（PHQ.9）”、年龄、女性和 BMI 之间存在直接联系，抑制也与自杀意念直接相关。DAG 显示“抑郁”、年龄和“抑制”与自杀意念之间存在联系，以及女性或单身/离异与患者自杀企图史之间存在联系。
研究结果表明，糖尿病患者自杀意念发生率较高，应在这些患者中密切监测这些症状。
