Jaser Sarah S., Roddy McKenzie K., Beam Aislinn B.
Vanderbilt University Medical Center, Department of Pediatrics, Nashville, TN
Vanderbilt University Medical Center, Department of Medicine, Nashville, TN
Psychosocial and behavioral health concerns for people with diabetes have received increased attention over the past several years, and since the publication of the American Diabetes Association’s position statement calling for psychosocial care for people with diabetes, screening and treatment options have become more widespread. In this review, we use national datasets to describe the prevalence of psychosocial and behavioral health conditions in people with diabetes, which occur at higher rates than in the general population. These datasets were selected due to their large sizes, representativeness of the samples, and measurement of relevant constructs. Lifetime prevalence of depression in adults with diabetes is 25% (compared to 20% in the general adult population); anxiety diagnoses are reported by 20% of adults with diabetes (compared to 17.5% of adults without diabetes); eating disorders occur in 10% of females with diabetes, and disordered eating occurs in up to 38% of people with diabetes. Diabetes distress is also commonly experienced by people with diabetes; >30% of people with both type 1 and type 2 diabetes report clinically significant levels of diabetes distress. In addition, we highlight the correlates and consequences of the psychosocial concerns most commonly experienced by people with diabetes, including depression, diabetes distress, anxiety, and disordered eating, as well as serious mental illnesses. Specifically, we note that females and young adults with diabetes are more likely to experience clinical diagnoses of depression, anxiety, and eating disorders than males or older adults with diabetes. Depression has been consistently associated with elevated glycemic outcomes in adults and youth, including higher glycated hemoglobin (A1C) levels and greater risk for diabetic ketoacidosis. In recent years, more studies have explored these topics in youth with diabetes and in representative populations. Finally, we identify measurement issues and review options for treatment and implications for clinical practice and future research.
在过去几年中，糖尿病患者的心理社会和行为健康问题受到了越来越多的关注。自美国糖尿病协会发表呼吁为糖尿病患者提供心理社会护理的立场声明以来，筛查和治疗选择已变得更加普遍。在本综述中，我们使用全国数据集来描述糖尿病患者心理社会和行为健康状况的患病率，这些状况在糖尿病患者中的发生率高于普通人群。选择这些数据集是因为它们规模大、样本具有代表性且对相关结构进行了测量。糖尿病成年患者中抑郁症的终生患病率为25%（普通成年人群为20%）；20%的糖尿病成年患者报告有焦虑症诊断（无糖尿病的成年人为17.5%）；10%的糖尿病女性患有饮食失调症，高达38%的糖尿病患者存在饮食紊乱情况。糖尿病患者也普遍经历糖尿病困扰；1型和2型糖尿病患者中超过30%报告有临床显著水平的糖尿病困扰。此外，我们强调了糖尿病患者最常经历的心理社会问题的相关因素和后果，包括抑郁症、糖尿病困扰、焦虑症和饮食紊乱，以及严重精神疾病。具体而言，我们注意到患有糖尿病的女性和年轻人比患有糖尿病的男性或老年人更有可能被临床诊断为抑郁症、焦虑症和饮食失调症。抑郁症一直与成年人和青少年的血糖升高结果相关，包括更高的糖化血红蛋白（A1C）水平和糖尿病酮症酸中毒的更大风险。近年来，更多研究在糖尿病青少年和代表性人群中探讨了这些主题。最后，我们确定了测量问题，并回顾了治疗选择以及对临床实践和未来研究的影响。
