Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes.
Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes.
复制标题
DOI：
10.1007/s00125-008-1113-x
复制
发表时间：
2008-10
期刊：
影响因子：
8.2
通讯作者：
Grant, R. W.
中科院分区：
文献类型：
--
作者：
Gonzalez, J. S.;Delahanty, L. M.;Safren, S. A.;Meigs, J. B.;Grant, R. W.
本研究的目的是研究抑郁症状与糖尿病特异性痛苦之间的关系，以及这些因素与糖尿病自我护理之间的独立关系。我们预期抑郁症状与较差的糖尿病自我护理有关，与糖尿病特有的痛苦无关。我们使用哈佛精神病学/国家抑郁症筛查日量表（HANDS）、糖尿病问题区域量表（PAID）、糖尿病自我护理活动总结和自我报告的药物依从性对848名2型糖尿病初级保健患者进行了调查。在总体样本中（r=0.54, p<0.0001），在根据HANDS筛查结果不符合重度抑郁症（MDD）诊断标准的患者中（n=685; r=0.36, p<0.001），以及在符合重度抑郁症筛查标准的患者中（n=163; r=0.36, p<0.001）， PAID和HANDS得分呈正相关。较高的PAID分数显著预测较低的饮食、运动和药物依从性（p值均<0.05）。然而，一旦抑郁症状得分进入这些模型，大多数关系被降低到不显著，而HANDS得分与糖尿病自我护理的大多数指标保持显著关系。在未筛查MDD阳性的患者亚组中发现了相同的结果模式。这些结果表明，即使在那些不符合重度抑郁症筛查标准的患者中，特定的抑郁症状与糖尿病自我护理的负相关程度大于糖尿病特定的痛苦。专注于改善特定抑郁症状管理的干预措施可能比专注于减少痛苦的干预措施更有效地改善自我保健。
The aim of this study was to examine the relationship between depressive symptoms and diabetes-specific distress and the independent relationships of each of these factors with diabetes self-care. We expected that symptoms of depression would be associated with poorer diabetes self-care, independent of diabetes-specific distress. We surveyed 848 primary care patients with type 2 diabetes using the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS), Problem Areas in Diabetes scale (PAID), Summary of Diabetes Self-Care Activities, and self-reported medication adherence. The PAID and HANDS scores were positively correlated in the overall sample (r=0.54, p<0.0001), among those who did not meet diagnostic criteria for major depressive disorder (MDD) based on the HANDS screening result (n=685; r=0.36, p<0.001) and in patients who did meet the screening criteria for MDD (n=163; r=0.36, p<0.001). Higher PAID scores significantly predicted lower levels of diet, exercise and medication adherence (all p values <0.05). However, once depression symptom scores were entered into these models, most relationships were reduced to non-significance, while the HANDS score retained significant relationships with most indices of diabetes self-care. The same pattern of results was found in the subset of patients who did not screen positive for MDD. These results suggest that specific symptoms of depression have a greater negative relationship with diabetes self-care than diabetes-specific distress, even among those patients who do not meet screening criteria for MDD. Interventions that focus on improving the management of specific symptoms of depression may be more effective in improving self-care than those that focus on reducing distress.
登录
查看更多内容
影响因子：
22.8
作者：
Baer, L;Jacobs, DG;O'Laughlen, J
通讯作者：
O'Laughlen, J
影响因子：
3.5
作者：
Delahanty, L. M.;Grant, R. W.;Meigs, J. B.
通讯作者：
Meigs, J. B.
影响因子：
16.2
作者：
Fisher, Lawrence;Skaff, Marilyn M.;Laurencin, Grace
通讯作者：
Laurencin, Grace
影响因子：
16.2
作者：
Vileikyte, L;Leventhal, H;Boulton, AJM
通讯作者：
Boulton, AJM
影响因子：
16.2
作者：
Gonzalez, Jeffrey S.;Safren, Steven A.;Grant, Richard W.
通讯作者：
Grant, Richard W.