Viinamäki H, Niskanen L, Uusitupa M
Department of Psychiatry, Kuopio University Hospital, Finland.
Acta Psychiatr Scand. 1995 Nov;92(5):392-7. doi: 10.1111/j.1600-0447.1995.tb09602.x.
We assessed the prevalence of minor mental disorder and depression in elderly patients with non-insulin-dependent (Type 2) diabetes mellitus as compared with control subjects and evaluated the associates of impaired mental well-being in diabetic patients. The study consists of a community-based group of patients (n = 82) with a 10 years' known duration of disease and nondiabetic control subjects (n = 115). In addition to clinical and laboratory examinations, self-rating questionnaires assessing minor mental disorder (General Health Questionnaire, GHQ) and depression (Zung Self-rating Depression scale) were completed by the patients and control subjects. The mean scores of GHQ and Zung scores tended to be higher in diabetic than in control subjects, but the frequency of case subjects was not different between the diabetic (GHQ: 40%; Zung: 11%) and nondiabetic groups (GHQ: 36%; Zung: 7%). These findings were explained by more severe symptoms in diabetic case subjects as compared to nondiabetic case-subjects. From the various parameters studied, the presence of symptomatic neuropathy was most strongly associated with depression and minor mental disorder in diabetic subjects. The results suggest that the impact of Type 2 diabetes per se on minor mental disorder or depression in elderly subjects is not overwhelming. However, a subgroup of diabetic patients seems to have markedly impaired mental well-being, and the treatment of its underlying factors may improve overall treatment compliance.
我们评估了非胰岛素依赖型(2型)糖尿病老年患者与对照受试者相比轻度精神障碍和抑郁症的患病率,并评估了糖尿病患者心理健康受损的相关因素。该研究包括一组以社区为基础的患者(n = 82),这些患者已知病程为10年,以及非糖尿病对照受试者(n = 115)。除了临床和实验室检查外,患者和对照受试者还完成了评估轻度精神障碍(一般健康问卷,GHQ)和抑郁症(zung自评抑郁量表)的自评问卷。糖尿病患者的GHQ和zung评分的平均分往往高于对照受试者,但糖尿病组(GHQ:40%;zung:11%)和非糖尿病组(GHQ:36%;zung:7%)之间病例受试者的频率没有差异。与非糖尿病病例受试者相比,糖尿病病例受试者症状更严重可以解释这些发现。从所研究的各种参数来看,有症状的神经病变的存在与糖尿病受试者的抑郁症和轻度精神障碍最密切相关。结果表明,2型糖尿病本身对老年受试者轻度精神障碍或抑郁症的影响并不压倒性。然而,一部分糖尿病患者似乎心理健康明显受损,对其潜在因素的治疗可能会提高总体治疗依从性。