2型糖尿病患者焦虑抑郁情绪与社会心理因素的关系

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。

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

Objective: To investigate association between psychosocial factors and anxious and depressive disorders in patients with diabetes mellitus. 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 body/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.