Diabetic peripheral neuropathy and depressive symptoms
Diabetic peripheral neuropathy and depressive symptoms
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DOI：
10.2337/diacare.28.10.2378
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发表时间：
2005-10-01
期刊：
影响因子：
16.2
通讯作者：
Boulton, AJM
中科院分区：
文献类型：
--
作者：
Vileikyte, L;Leventhal, H;Boulton, AJM
目的-我们研究了糖尿病周围神经病变的严重程度和抑郁症状之间的关系，并调查了这种关系的潜在介质。研究设计和方法-医院焦虑和抑郁量表（HADS）被用来评估494例患者的抑郁症状（平均年龄62岁; 70%为男性; 72%为2型糖尿病患者），通过神经病残疾评分（NDS）和振动感知阈值（VPT）诊断为糖尿病性神经病变。糖尿病神经病变症状、日常生活活动能力（ADL）和社会自我知觉采用神经病变和足部溃疡特异性生活质量量表NeuroQoL进行测量;糖尿病神经病变症状的不可预测性和缺乏有效治疗的看法进行了评估，修订的疾病感知问卷。在控制人口统计学和疾病变量后，NDS和VPT与HADS显著相关。虽然糖尿病神经病变症状介导了这种关联，其中不稳定性与HADS的关联性最强，但足部溃疡与抑郁之间的关系并不显著。糖尿病神经病变症状和HADS之间的关联部分由两组社会心理变量介导：1）对糖尿病神经病变症状不可预测性和缺乏治疗控制的看法; 2）ADL的限制和社会自我感知的变化。这些发现建立了糖尿病神经病变和抑郁症状之间的联系，并确定了缓解抑郁症状的干预措施的潜在目标糖尿病性周围神经病变患者。
OBJECTIVE - We examined the association between severity of diabetic peripheral neuropathy and depressive symptoms and investigated the potential mediators of this association.RESEARCH DESIGN AND METHODS - The Hospital Anxiety and Depression Scale (HADS) was used to assess depressive symptoms in 494 patients (mean age 62 years; 70% male; 72% type 2 diabetic) with diabetic neuropathy diagnosed by the Neuropathy Disability Score (NDS) and the Vibration Perception Threshold (VPT). Diabetic neuropathy symptoms, activities of daily living (ADLs), and social self-perception were measured by the neuropathy and foot ulcer-specific quality-of-life instrument, NeuroQoL; perceptions of diabetic neuropathy symptom unpredictability and the lack of effective treatment were assessed by the revised Illness Perception Questionnaire.RESULTS - Both the NDS and VPT were significantly associated with the HADS after controlling for demographic and disease variables. Although diabetic neuropathy symptoms mediated this association, with unsteadiness being most strongly associated with HADS, the relationship between foot ulceration and depression was nonsignificant. The association between diabetic neuropathy symptoms and HADS was partially mediated by two sets of psychosocial variables: 1) perceptions of diabetic neuropathy symptom unpredictability and the lack of treatment control and 2) restrictions in ADLs and changes in social self-perception.CONCLUSIONS - These findings establish the association between diabetic neuropathy and depressive symptoms and identify potential targets for interventions to alleviate depressive symptoms in persons affected by diabetic peripheral neuropathy.