Prevalence of depression in Type 1 diabetes and the problem of over-diagnosis
Prevalence of depression in Type 1 diabetes and the problem of over-diagnosis
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DOI：
10.1111/dme.12973
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发表时间：
2016-11-01
影响因子：
3.5
通讯作者：
Strycker, L. A.
中科院分区：
文献类型：
--
作者：
Fisher, L.;Hessler, D. M.;Strycker, L. A.
AimsTo确定抑郁症和糖尿病的患病率与1型糖尿病的成年人和假阳性率相比，主要depressive disorder.MethodsThe样本由368人与1型糖尿病，年龄19岁。个人完成：八项患者健康问卷抑郁量表（PHQ 8），使用四个评分标准进行编码（评分10、12和15，以及精神障碍诊断和统计手册5（DSM）算法评分）; 1型糖尿病痛苦量表;和DSM疾病结构化临床访谈（SCID）来评估重度抑郁症。项目患者健康问卷：得分10分，11.4%;得分12分，7.1%;得分15分，3.8%;和阳性算法结果，4.6%。重度抑郁症的患病率为3.5%;至少中度糖尿病困扰的患病率为42.1%。根据所使用的标准，使用患者健康问卷时的假阳性率与使用SCID时的结果相比，从52%到71%不等。在PHQ-8或DSM疾病结构化临床访谈中被归类为抑郁的人中，92.3%至96.2%的人也报告了糖尿病痛苦增加。根据PHQ 8或SCID和HbA（1c）浓度被归类为抑郁症的任何组之间均未发现显著相关性。抑郁症与更多的其他生活压力，更多的并发症和较低的教育水平显着相关。ConclusionsWe发现了一个意想不到的低利率，目前的抑郁症和严重抑郁症在这个不同的样本中的成年1型糖尿病患者，和一个非常高的假阳性结果使用患者健康问卷调查。考虑到糖尿病困扰的高患病率，1型糖尿病成年人中被认为是抑郁症的大部分可能归因于与管理高要求的慢性疾病和其他生活压力源相关的情绪困扰，而不一定是潜在的精神病理学。
AimsTo determine the prevalence of depression and diabetes distress in adults with Type 1 diabetes and the rate of false-positives when compared with rates of major depressive disorder.MethodsThe sample consisted of 368 individuals with Type 1 diabetes, aged 19 years. Individuals completed: the eight-item Patient Health Questionnaire depression scale (PHQ8), which was coded using four scoring criteria (scores 10, 12 and 15, and Diagnostic and Statistical Manual of Mental Disorders 5 (DSM) algorithm scores); the Type 1 Diabetes Distress Scale; and the Structured Clinical Interview for DSM Disorders (SCID) to assess major depressive disorder.ResultsThe prevalence rates of depression according to the eight-item Patient Health Questionnaire were: score10, 11.4%; score 12, 7.1%; score 15, 3.8%; and positive algorithm result, 4.6%. The prevalence of major depressive disorder was 3.5%; and the prevalence of at least moderate diabetes distress was 42.1%. Depending on the criterion used, the false-positive rate when using the Patient Health Questionnaire compared with the results when using the SCID varied from 52 to 71%. Of those classified as depressed on the PHQ-8 or Structured Clinical Interview for DSM Disorders, between 92.3 and 96.2% also reported elevated diabetes distress. No significant association was found between any group classed as having depression according to the PHQ8 or the SCID and HbA(1c) concentration. Depression was significantly associated with more other life stress, more complications and a lower level of education.ConclusionsWe found an unexpectedly low rate of current depression and major depressive disorder in this diverse sample of adults with Type 1 diabetes, and a very high rate of false-positive results using the Patient Health Questionnaire. Considering the high prevalence of diabetes distress, much of what has been considered depression in adults with Type 1 diabetes may be attributed to the emotional distress associated with managing a demanding chronic disease and other life stressors and not necessarily to underlying psychopathology.