Spiess K, Sachs G, Moser G, Pietschmann P, Schernthaner G, Prager R
Institute of Medical Psychology, Vienna University, Austria.
J Psychosom Res. 1994 Apr;38(3):249-58. doi: 10.1016/0022-3999(94)90120-1.
The relationships between psychosocial adjustment and subsequent glycaemic control were prospectively examined in forty-three adult patients during the first 2 yr after onset of type 1 diabetes mellitus. Decreasing depression was the single psychosocial parameter that changed over time. No correlations were found between the decrease in HbA1c levels and psychological variables at 8- and 16-month follow-ups. Global and specific coping features such as high control attitude, low coping anxiety and low emotional attribution correlated significantly with the decrease in HbA1c levels at the 2-yr follow-up, whereas stressful life events, depression, state-trait anxiety did not correlate. In a regression analysis coping explained 22% variance of the 2 yr decrease in HbA1c levels. We conclude that coping is a better predictor for metabolic control than emotional adaptation and life events. Metabolic control might deteriorate with prolonged stage of the disease being a first sign for psychophysiological coping exhaustion.
在43例1型糖尿病成年患者发病后的头2年，对其社会心理调适与后续血糖控制之间的关系进行了前瞻性研究。抑郁程度降低是唯一随时间变化的社会心理参数。在8个月和16个月随访时，未发现糖化血红蛋白（HbA1c）水平下降与心理变量之间存在相关性。在2年随访时，诸如高度控制态度、低应对焦虑和低情绪归因等整体和特定应对特征与HbA1c水平下降显著相关，而应激性生活事件、抑郁、状态-特质焦虑则无相关性。在回归分析中，应对解释了HbA1c水平2年下降变异的22%。我们得出结论，与情绪适应和生活事件相比，应对是代谢控制更好的预测指标。随着疾病病程延长，代谢控制可能恶化，这是心理生理应对耗竭的首个迹象。
