Lawrence Jean M, Standiford Debra A, Loots Beth, Klingensmith Georgeanna J, Williams Desmond E, Ruggiero Andrea, Liese Angela D, Bell Ronny A, Waitzfelder Beth E, McKeown Robert E
Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
Pediatrics. 2006 Apr;117(4):1348-58. doi: 10.1542/peds.2005-1398.
The objective of this study was to determine if depressed mood among youth with diabetes was associated with type and duration of diabetes, mean glycosylated hemoglobin (HbA1c) level, and the frequency of diabetic ketoacidosis (DKA) and hypoglycemic episodes, hospitalizations, and emergency department (ED) visits.
A total of 2672 youth (aged 10-21 years) who had diabetes for a mean duration of 5 years completed a SEARCH study visit, in which their HbA1c was measured and information about their demographic characteristics, diabetes type and duration, and episodes of DKA, hypoglycemia, hospitalizations, and ED visits over the previous 6 months was collected. Their level of depressed mood was measured using the Center for Epidemiologic Studies Depression Scale (CES-D).
Among these youth, 14% had mildly (CES-D 16-23) and 8.6% had moderately or severely (CES-D > or =24) depressed mood. Females had a higher mean CES-D score than males. After adjusting for demographic factors, and duration of diabetes, we found the prevalence of depressed mood to be higher among males with type 2 diabetes than those with type 1 diabetes and to be higher among females with comorbidities than those without comorbidities. Higher mean HbA1c and frequency of ED visits were associated with depressed mood. The prevalence of depressed mood among youth with diabetes was similar to that of published estimates of depressed mood among youth without diabetes.
Physicians and other health care professionals should consider screening youth with diabetes for depressed mood in clinical settings, particularly youth with poor glycemic control, those with a history of frequent ED visits, males with type 2 diabetes, and females with comorbidities.
本研究的目的是确定糖尿病青少年的抑郁情绪是否与糖尿病的类型和病程、平均糖化血红蛋白(HbA1c)水平、糖尿病酮症酸中毒(DKA)和低血糖发作的频率、住院次数以及急诊科就诊次数有关。
共有2672名平均病程为5年的青少年(年龄在10 - 21岁之间)完成了SEARCH研究访视,在访视中测量了他们的HbA1c,并收集了有关他们的人口统计学特征、糖尿病类型和病程以及过去6个月内DKA、低血糖、住院和急诊科就诊情况的信息。使用流行病学研究中心抑郁量表(CES - D)测量他们的抑郁情绪水平。
在这些青少年中,14%有轻度(CES - D 16 - 23)抑郁情绪,8.6%有中度或重度(CES - D≥24)抑郁情绪。女性的平均CES - D得分高于男性。在调整了人口统计学因素和糖尿病病程后,我们发现2型糖尿病男性的抑郁情绪患病率高于1型糖尿病男性,有合并症的女性的抑郁情绪患病率高于无合并症的女性。较高的平均HbA1c和急诊科就诊频率与抑郁情绪有关。糖尿病青少年的抑郁情绪患病率与未患糖尿病青少年抑郁情绪的已发表估计值相似。
医生和其他医疗保健专业人员应在临床环境中考虑对糖尿病青少年进行抑郁情绪筛查,特别是血糖控制不佳的青少年、有频繁急诊科就诊史的青少年、2型糖尿病男性以及有合并症的女性。