Reciprocal Relationships between Diabetes and Depression

糖尿病和抑郁症之间的相互关系

• 批准号: 7024491
• 负责人: PATRICK J O'CONNOR
• 金额: $ 30.36万
• 依托单位: HEALTHPARTNERS INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-03-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7024491
• 关键词: adult human (21+); clinical research; comorbidity; depression; diabetes mellitus; epidemiology; health behavior; human data; longitudinal human study; medical complication; therapy compliance

DESCRIPTION (provided by applicant): The objective of this project is to provide a better understanding of the intricate and complex reciprocal relationship between diabetes and depression, in order to provide more effective clinical care to the 1,600,000 million Americans who suffer from both these chronic conditions. This four-year project has three specific aims (1) To understand how diabetes mellitus in adults affects the onset and management of clinically significant depression, (2) To understand how clinically significant depression affects the management, progression, and outcomes of diabetes mellitus in adults, and (3) To compare the relative strength of influence of depression on diabetes and diabetes on depression. The project is conducted at Health Partners Medical Group in Minnesota, and takes advantage of sophisticated chronic disease surveillance systems already in place in a well-defined primary care population of 175,000 adults. An incident cohort of 1,000 adults with diabetes and a prevalence cohort of 3,000 patients with diabetes are each age-, gender-, and clinic/appointment date matched to a study subject without diabetes. These cohorts are tracked over a 4-year period to enable specification of temporal relationships. Linear regression, logistic regression, and structural equation modeling are used to test seven specific hypotheses, which will advance our understanding of how to improve the care provided to patients with both conditions. Strengths of the study include the following: (a) an experienced research team with a proven research record in diabetes, depression, quality improvement, and health services research; (b) a well-characterized study population; (c) prior development of validated methods to identify diabetes and depression, and measures of comorbidity, pharmaceutical treatment, medication adherence, and utilization of care using automated data, and (d) prior success improving diabetes quality of care using a similar set of strategies. This project will provide important missing information needed to improve the care of millions of people worldwide who suffer the devastating consequences of comorbid diabetes and depression.

该项目的目的是更好地了解糖尿病和抑郁症之间错综复杂的相互关系，以便为1，600，000万患有这两种慢性疾病的美国人提供更有效的临床护理。这个为期四年的项目有三个具体目标：（1）了解成人糖尿病如何影响临床显著抑郁症的发作和管理;（2）了解临床显著抑郁症如何影响成人糖尿病的管理、进展和结局;（3）比较抑郁症对糖尿病和糖尿病对抑郁症影响的相对强度。该项目在明尼苏达州的Health Partners Medical Group进行，并利用了在175，000名成年人的明确初级保健人群中已经存在的复杂慢性病监测系统。将1,000名糖尿病成人的事件队列和3,000名糖尿病患者的患病率队列的年龄、性别和门诊/预约日期分别与无糖尿病的研究受试者匹配。这些队列在4年的时间内进行跟踪，以便能够说明时间关系。线性回归，逻辑回归和结构方程模型被用来测试七个具体的假设，这将促进我们对如何改善为这两种情况的患者提供的护理的理解。该研究的优势包括：（a）一个经验丰富的研究团队，在糖尿病、抑郁症、质量改进和卫生服务研究方面有着良好的研究记录;（B）一个特征明确的研究人群;（c）预先开发有效的方法来识别糖尿病和抑郁症，以及使用自动化数据测量合并症、药物治疗、药物依从性和护理利用，以及（d）使用类似的一组策略改善糖尿病护理质量的先前成功。该项目将提供重要的缺失信息，以改善全世界数百万患有糖尿病和抑郁症共病的人的护理。