糖尿病前期患者餐后2h血糖水平与心理因素的关系  

Relationship between plasma glucose levels and psychological risk factors in patients with prediabetes

作　　者：张婷[1] 高东[1] 蒋成刚[1] 乐发国[1] 张岚[2] 余叶蓉[3] 陆峥[4] 高成阁[5] 王旭梅[6] 谭庆荣[7] 徐建平[8] 卢勤[9] 孙学礼[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所睡眠心理中心,重庆400042 [2]四川大学华西医院心理卫生中心,成都610041 [3]四川大学华西医院内分泌科,成都610041 [4]上海市同济大学附属同济医院精神科,上海200065 [5]西安交通大学医学院第一附属医院精神科,西安710061 [6]中国医科大学附属医院心理科,沈阳110004 [7]第四军医大学附属第一医院心身科,西安710032 [8]北京师范大学心理学院,北京100009 [9]成都大学心理健康教育与研究中心,成都610106

出　　处：《中国心理卫生杂志》2014年第7期486-491,共6页Chinese Mental Health Journal

基　　金：十一五国家科技支撑计划项目(2009BAI77B06)

摘　　要：目的：探讨糖尿病前期患者餐后2h血糖水平与抑郁、焦虑、述情障碍、应对方式、人格等心理因素的相关性.方法：选取符合美国糖尿病协会糖尿病诊疗指南中糖尿病前期诊断标准[7.8 mmol/L≤餐后2h血糖（P2h-PG） ＜11.1 mmol/L]的门诊患者440例,使用自评抑郁量表（SDS）、焦虑自评量表（SAS）、多伦多述情障碍量表（TAS）、特质应对方式问卷（TCSQ）、简式大五人格问卷（NEO-FFIR）评估其抑郁症状、焦虑症状、述情障碍、应对方式及人格特点.结果：患者P2h-PG水平与SDS得分（40.0±8.0）、SAS得分（54.7±10.9）、TAS得分（68.2±9.7）、TCSQ消极应对得分（30.4±7.1）和NEO-FFI-R神经质得分（3.0±0.6）正相关（r=0.13～0.24;均P＜0.01）.多元线性回归分析显示,P2h-PG水平与SDS得分呈正向关联,与NEO-FFI-R谨慎性得分负向关联（标准化β=0.21、-0.18;均P＜0.01）;SDS得分与SAS、TAS得分正向关联,与TCSQ积极应对得分负向关联（标准化β=0.51、0.13、-0.13;均P＜0.01）;SAS得分与SDS得分、TAS得分、NEO-FFI-R神经质得分和谨慎性得分正向关联,与NEO-FFI-R宜人性得分负向关联（标准化β=0.22、0.17、0.14、-0.14、0.13;均P＜0.01）.结论：本研究提示,糖尿病前期患者的血糖升高与抑郁、焦虑、述情障碍、消极应对方式、神经质等心理因素相关,其中与抑郁的相关程度较高.Objective：To explore the association between plasma glucose levels and psychological factors,such as depression,anxiety,alexithymia,coping style,and personality in patients with prediabetes.Methods：Totally 440 out-patients with the prediabetes （7.8mmol/L ≤ P2h-PG ＜ 11.1 mmol/L） according to Diabetes Treatment Guidelines of American Diabetes Association criteria were selected.The psychological state was assessed with the Self-rating Depression Scale （SDS）,Self-rating Anxiety Scale （SAS）,Toronto Alexithymia Scale （TAS）,Trait Coping Style Questionnaire （TCSQ）,and Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI-R）.Results：The plasma levels of P2h-PG were positively correlated with the scores of SDS （40.0 ± 8.0）,SAS （54.7 ± 10.9）,TAS （68.2 ± 9.7）,TCSQ ＂negative coping＂ （30.4 ± 7.1） and NEO-FFI-R ＂neuroticism＂ （3.0 ±0.6） （r =0.13-0.24,Ps ＜0.01）.Multiple linear regression analysis showed the P2h-PG levels were positively associated with scores of SDS and negatively associated with scores of NEO-FFI-R ＂caution＂ （β=0.21,-0.18; P ＜0.01）.The SDS scores were positively associated with the scores of SAS and TAS,but negatively associated with score of TCSQ ＂positive coping style＂（β =0.51,0.13,-0.13; P ＜0.01）.The SAS scores were positively associated with the score of SDS,TAS and NEO-FFI-R ＂neuroticism＂ and ＂caution＂,and negatively associated with the scores of NEO-FFI-R ＂agreeableness＂ （β =0.22,0.17,0.14,-0.14,0.13; P ＜ 0.01）.Conclusion：This study indicates that the increased plasma glucose levels are associated with depression,anxiety,personality,alexithymia and negative coping style in patients with prediabetes,and the association with depression may be significant.

关 键 词：糖尿病前期 抑郁 焦虑 述情障碍 应对方式 人格 现况调查 

分 类 号：R749.92[医药卫生—神经病学与精神病学] R587.1[医药卫生—临床医学]