中国文化背景下糖尿病合并抑郁患者躯体症状归因及特点分析

The characteristic of somatic symptoms of diabetic patients comorbided with depression under the background of Chinese culture

目的 :调查分析中国文化背景下糖尿病合并抑郁患者躯体症状归因及特点。方法 :方便取样选择住院2型糖尿病患者137例,采用流调中心用抑郁量表(CES-D)筛查抑郁状态、躯体症状指数问卷(SSI)评估躯体症状、中文版糖尿病烦恼量表(DDS)评估糖尿病相关的不良情绪,并行单因素相关分析和多元线性回归分析。结果 :本组患者24.8%处于抑郁状态,抑郁组DDS总分、SSI总分以及躯体症状数目均高于未合并抑郁者;SSI总分与文化程度呈负相关(r=-0.216,P=0.011)、与是否合并并发症呈正相关(r=0.225,P=0.008);与年龄(r=0.191,P=0.025)、并发症数(r=0.335,P<0.001)、CES-D总分(r=0.466,P<0.001)、DDS总分(r=0.392,P<0.001)呈正相关。多元线性回归分析显示CES-D总分、DDS总分、并发症数共解释SSI总分39.1%的变异(P<0.001)。结论 :中国文化背景下糖尿病合并抑郁患者具有更多的躯体症状,糖尿病躯体症状与抑郁的躯体化表现有重叠,主诉躯体症状多是识别抑郁的重要线索。

Objectives： To analyse the characteristic of somatic symptoms of Chinese diabetic patients comorbided with depression. Method： Totally 137 T2 DM inpatients were included. Centre for Epidemiological Studies Depression Scale（CES-D） was used to screening depression symptoms and SSI was used to assess the somatic symptoms with the Chinese version of DDS assessing diabetes related emotional distress. Results： The prevalence of depression was 24.8%. DDS score, SSI score and the number of somatic symptoms in depression group was significantly higher than non-depression group. SSI score was negatively related to education level（r=-0.216, P=0.011）, positively related to comorbidity of complicaiton（r=0.225, P=0.008）, positively related to age（r=0.191, P=0.025）, positively related to the number of complications（r =0.335, P〈0.001）, positively related to CES-D score（r=0.466, P〈0.001） and DDS score（r=0.392, P〈0.001）. Multiple linear stepwise regression analysis showed that CES-D score, DDS score and the number of complications entered the equation and could explain 39.1% of the variation of SSI score（P〈0.001）. Conclusion： Chinese diabetic patients complicated with depression tended to have more somatic symptoms. There were overlapping in somatic symptoms of diabetes and somatization symptom of depression. Complaining of increasing somatic symptoms was a clue to identify depression in patients with diabetes.