Goldston D B, Kovacs M, Obrosky D S, Iyengar S
Department of Psychiatry, Bowman Gray School of Medicine, Wake Forest University, USA.
Health Psychol. 1995 Sep;14(5):409-14. doi: 10.1037//0278-6133.14.5.409.
In a study of school-age children with new-onset insulin-dependent diabetes mellitus (IDDM), life stress, metabolic control (glycosylated hemoglobin), and psychiatric and psychosocial variables were assessed repeatedly for up to 6 years. Life stress was defined as the number of undesirable life events and extent of life change necessitated by all life events. In univariate longitudinal analyses, total life change units were related to metabolic control, with a trend for number of undesirable events to be associated with metabolic control. In multivariate analyses, metabolic control was related to life change units, whether the glycosylated hemoglobin was in the 1st year of IDDM, IDDM duration, and the diagnosis of pervasive noncompliance with medical regimen. The relationship of life stress to metabolic control among youths with diabetes in significant but clinically modest and may be partially mediated by serious noncompliance with the medical regimen.
在一项针对新发性胰岛素依赖型糖尿病(IDDM)学龄儿童的研究中,对生活压力、代谢控制(糖化血红蛋白)以及精神和社会心理变量进行了长达6年的反复评估。生活压力被定义为不良生活事件的数量以及所有生活事件所必需的生活变化程度。在单变量纵向分析中,总生活变化单位与代谢控制相关,不良事件数量有与代谢控制相关的趋势。在多变量分析中,无论糖化血红蛋白是在IDDM的第1年、IDDM病程以及普遍不遵守医疗方案的诊断情况如何,代谢控制都与生活变化单位相关。生活压力与糖尿病青少年代谢控制之间的关系显著但在临床上程度适中,且可能部分由严重不遵守医疗方案所介导。