Röhrig Bonnie, Petrak Frank, Bartel Alina, Hagena Verena, Dieris-Hirche Jan, Meier Juris M, Herpertz Stephan
Zentrum für Psychotherapie Wiesbaden MVZ GmbH, Germany.
Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum Bochum der Ruhr-Universität Bochum, Bochum, Germany.
Psychother Psychosom Med Psychol. 2024 Nov;74(11):446-453. doi: 10.1055/a-2401-5152. Epub 2024 Oct 24.
Diabetes mellitus is associated with an increased likelihood of mental disorders, especially depression. Despite a frequently postulated underprovision, the actual need for psychotherapeutic treatment in this patient group has hardly been investigated. The aim of this study is to analyze the care situation of diabetes patients with mental comorbidities in Germany.
240 consecutively treated patients with type 1 or type 2 diabetes were examined cross-sectionally and longitudinally in a tertiary diabetological center. After a screening and diagnostic examination, 94 patients with comorbid mental disorders were included in the study. Patients then decided on the treatment of their mental disorder according to a standardized shared decision-making process. At the 6-month follow-up, 77 of the 94 patients (81.9%) provided information about the realization of their treatment decision and the obstacles they encountered.
39.2% of patients with diabetes had a mental disorder. Of these, 44.2% were already receiving psychotherapy or medication. After six months, 46.8% were able to implement their treatment decision. Only 7.1% did not receive any treatment despite their efforts. The 6-month follow-up showed a significant reduction in diabetes-related distress (PAID; p<0.05) and an increase in psychological well-being in all subgroups, regardless of treatment initiation (WHO-5; p<0.05).
Contrary to the widespread notion of a lack of access to psychotherapy for people with diabetes and mental disorders in Germany, this assumption could not be confirmed in this study.
Equating the frequency of mental disorders with the need for psychotherapeutic and/or psychopharmacological treatment without considering the specific treatment needs and preferences of patients may lead to an overestimation of the need for care.
糖尿病与精神障碍尤其是抑郁症的患病可能性增加有关。尽管人们经常假定心理治疗服务供应不足，但该患者群体对心理治疗的实际需求几乎未得到研究。本研究的目的是分析德国患有精神共病的糖尿病患者的护理情况。
在一家三级糖尿病中心对240例连续接受治疗的1型或2型糖尿病患者进行横断面和纵向检查。经过筛查和诊断检查后，94例患有精神共病的患者被纳入研究。然后患者根据标准化的共同决策过程决定其精神障碍的治疗方案。在6个月的随访中，94例患者中有77例（81.9%）提供了有关其治疗决策的实施情况以及所遇到障碍的信息。
39.2%的糖尿病患者患有精神障碍。其中，44.2%的患者已经在接受心理治疗或药物治疗。6个月后，46.8%的患者能够实施其治疗决策。尽管努力，但只有7.1%的患者未接受任何治疗。6个月的随访显示，无论是否开始治疗，所有亚组中与糖尿病相关的痛苦（糖尿病痛苦量表；p<0.05）均显著降低，心理健康状况有所改善（世界卫生组织-5幸福指数；p<0.05）。
与德国普遍认为糖尿病和精神障碍患者难以获得心理治疗的观点相反，本研究未能证实这一假设。
在不考虑患者具体治疗需求和偏好的情况下，将精神障碍的发生率等同于心理治疗和/或精神药物治疗的需求，可能会导致对护理需求的高估。
