2型糖尿病患者焦虑抑郁情绪与社会心理因素的关系

The Relationship of Anxious and Depressive Disorders with Psychosocial Factors in Patients with Type 2 Diabetes Mellitus

目的：探讨2型糖尿病患者焦虑、抑郁情绪与心理压力、应对方式和社会支持的关系。方法：采用自填式问卷，对172名2型糖尿病患者进行调查，了解患者的一般情况、心理压力来源、病人应对措施、社会支持等社会心理因素，同时用医院焦虑抑郁量表（HAD）测量其焦虑与抑郁情况。结果：焦虑得分≥9分者35人，占20．3％；抑郁得分≥9分者33人，占19．2％。控制性别、年龄、婚姻状况、学历、经济收入等潜在的混杂因素后的多因素logistic回归分析表明，感受“担心疾病可能造成的伤害”（OR=1．76，95％CI=1．12-2．77）、“疾病造成的社会／家庭危机感”（OR=1．85，95％CI=1．18-2．92）、“担心身体／生理功能下降”（OR=2．16，95％CI=1．28～3．67）和“担心经济条件降低”（OR=2．03，95％CI=1．27～3．26）的压力越大，对疾病越多采取“消极应对”的措施（OR=1．94，95％CI=1．26-2．97），越容易出现焦虑情绪：感受“疾病造成的社会／家庭危机感”（OR=1．79，95％CI=1．09～2．96）、“担心身体／生理功能下降”（OR=2．89，95％CI=1．59-5．24）的压力越大，对疾病越多采取“消极应对”的措施（OR=1．95，95％CI=1．23～3．11），越容易出现抑郁情绪，较多采取“逃避”的应对措施者较少出现抑郁情绪（OR=0．52，95％CI=0．30-0．90）。结论：2型糖尿病人的焦虑、抑郁情绪与疾病引起的心理紧张和病人采取的应对方式有关。

Objective： To investigate association between psychosoeial factors and anxious and depressive disorders in patients with diabetes meUitus. Methods： 172 patients with type 2 diabetes were inquired with a self-administered questionnaire about their socio-demographic characteristics, perceived stress caused by the disease, coping styles, social support. At the same time, anxious and depressive disorders were assessed with HAD. Results： Among our sample, 35 （20. 3%） patients with anxiety, 33 （ 19. 2% ） with depression. After adjusting for gender, age, marital status , educational level and income, multivariate logistic regression analysis found the following results. Perceived stress from ＂ Worrying about to be harmed by the disease＂ （ OR=1.76, 95% CI 1.12 -2.77 ）,＂ Social/family crisis caused by the disease＂ （OR=1.85, 95% CI 1.18-2. 92） ,＂ Worrying about declining in hody/physical function＂ （OR=2. 16, 95%CI 1.28-3.67）, ＂ Declined economic condition＂ （OR=2.03, 95%CI 1.27-3.26） and ＂ Negative coping styles＂ （OR=1.94, 95% CI 1.26-2. 97） were significantly associated with anxious disorders. The perceived stress from ＂ Social/family crisis caused by disease＂ （ OR = 1.79, 95% CI 1.09-2.96 ） , ＂ Worrying about declining in body/physical function＂ （ OR=2. 89, 95% CI 1.59-5.24 ）and ＂ Negative coping styles＂ （OR = 1.95, 95%CI 1.23-3. 11） were significantly associated with depressive disorders, while patients ＂ Taking avoidant measures＂ （OR = 0. 52, 95% CI 0. 30-0.90） were less depressive disorders. Conclusion： Anxious and depressive disorders in patients with 2 type diabetes were significantly associated with patients＇ perceived stress from the disease and their coping styles.