摘要
目的:了解2型糖尿病患者抑郁状态及其生理、心理、社会影响因素,探讨疾病感知、疾病痛苦在血糖控制与抑郁状态间的中介效应。方法:选取住院2型糖尿病患者511人,进行一般人口学信息、疾病感知问卷、中文版糖尿病痛苦量表、抑郁自评问卷调查,同时进行体质量指数(BMI)、糖化血红蛋白(HbA1c)等生理指标检测。结果:2型糖尿病患者抑郁得分为[(57.48±9.94)分],无抑郁138例(27.0%),轻度抑郁状态179例(35%),中度抑郁状态174例(34.1%),重度抑郁状态20例(3.9%)。抑郁状态与血糖控制不佳(r=0.157,P<0.01)、疾病感知(r=0.359,P<0.01)、疾病痛苦的四个维度(r=0.177~0.354,P<0.01)呈正相关。疾病感知在血糖控制和抑郁状态间起到部分中介作用(B=0.216,95%CI=0.112~0.372,占总效应25.9%)。疾病感知和疾病痛苦在血糖控制和抑郁状态间存在链式中介作用(B=0.086,95%CI=0.042~0.149,占总效应10.3%)。结论:血糖控制是2型糖尿病患者抑郁状态的重要影响因素,可以通过影响疾病感知进而影响疾病痛苦的人际相关痛苦来影响抑郁状态。
Objective:To investigate the status of depression and physiological,psychological and social factors among people with type 2 diabetes(T2DM),as well as the mediating effects of illness perception and diabetes distress on glycemic control and depression.Methods:A total of 511 patients with type 2 diabetes were recruited and investigated using general demographic questionnaire,self-rating depression scale(SDS),brief illness perception questionnaire(BIPQ)and diabetes distress scale(DDS).Body mass index(BMI)and hemoglobin a1c(HbA1c)were detected in laboratory.Results:The mean score of SDS was(57.48±9.94).The distribution of depression condition were 138(27.0%)without depression,179(35%)with mild depression,174(34.1%)with moderate depression and 20(3.9%)with severe depression.SDS score was significantly positively correlated with poor glycemic control(r=0.157,P<0.01),illness perception(r=0.359,P<0.01)and four dimensions of diabetes distress(r=0.177-0.354,P<0.01).Partially mediating effect of illness perception(B=0.216,95%CI=0.112-0.372)was found in glycemic control and depression,the proportion of effect was 25.9%.The chain mediating effect(B=0.086,95%CI=0.042-0.149)of illness perception and diabetes distress was also found between glycemic control and depression,whose indirect effect size was 10.3%.Conclusion:Glycemic control is significantly related with depression.Illness perception and diabetes distress are partly mediating the effect between glycemic control and depression.
作者
张天宇
项莹
宋雪佳
杨艳杰
邱晓惠
李平
Zhang Tianyu;Xiang Ying;Song Xuejia;Yang Yanjie;Qiu Xiaohui;Li Ping(Department of Medical Psychology,School of Public Health,Harbin Medical University,Harbin 150081,China;Department of Endocrinology,the Second,Affiliated Hospital of Harbin Medical University,Harbin 150081,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2020年第7期620-623,共4页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家自然科学基金项目(81773536)。
关键词
2型糖尿病
抑郁
血糖控制
疾病感知
疾病痛苦
Type 2 diabetes m ellitus
Depression
Glycemic control
Illness perception
Illness distress
