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Diabetes Distress, Depressive Symptoms, and Anxiety Symptoms in People With Type 2 Diabetes: A Network Analysis Approach to Understanding Comorbidity
Diabetes Care ( IF 16.2 ) Pub Date : 2022-06-15 , DOI: 10.2337/dc21-2297
Amy M McInerney 1 , Nanna Lindekilde 2 , Arie Nouwen 3 , Norbert Schmitz 4, 5 , Sonya S Deschênes 1
Affiliation  

OBJECTIVE In this study, we aimed to explore interactions between individual items that assess diabetes distress, depressive symptoms, and anxiety symptoms in a cohort of adults with type 2 diabetes using network analysis. RESEARCH DESIGN AND METHODS Participants (N = 1,796) were from the Montreal Evaluation of Diabetes Treatment (EDIT) study from Quebec, Canada. A network of diabetes distress was estimated using the 17 items of the Diabetes Distress Scale (DDS-17). A second network was estimated using the DDS-17 items, the nine items of the Patient Health Questionnaire (PHQ-9), and the seven items of the Generalized Anxiety Disorder Assessment (GAD-7). Network analysis was used to identify central items, clusters of items, and items that may act as bridges between diabetes distress, depressive symptoms, and anxiety symptoms. RESULTS Regimen-related and physician-related problems were among the most central (highly connected) and influential (most positive connections) in the diabetes distress network. The depressive symptom of failure was found to be a potential bridge between depression and diabetes distress, being highly connected to diabetes distress items. The anxiety symptoms of worrying too much, uncontrollable worry, and trouble relaxing were identified as bridges linking both anxiety and depressive items and anxiety and diabetes distress items, respectively. CONCLUSIONS Regimen-related and physician-related diabetes-specific problems may be important in contributing to the development and maintenance of diabetes distress. Feelings of failure and worry are potentially strong candidates for explaining comorbidity. These individual diabetes-specific problems and mental health symptoms could hold promise for targeted interventions for people with type 2 diabetes.

中文翻译:

2 型糖尿病患者的糖尿病困扰、抑郁症状和焦虑症状:了解合并症的网络分析方法

目的 在本研究中,我们旨在使用网络分析探索在 2 型糖尿病成人队列中评估糖尿病困扰、抑郁症状和焦虑症状的各个项目之间的相互作用。研究设计和方法 参与者 (N = 1,796) 来自加拿大魁北克的蒙特利尔糖尿病治疗评估 (EDIT) 研究。使用糖尿病困扰量表 (DDS-17) 的 17 个项目估计了糖尿病困扰网络。使用 DDS-17 项目、患者健康问卷 (PHQ-9) 的 9 个项目和广泛性焦虑症评估 (GAD-7) 的 7 个项目来估计第二个网络。网络分析用于识别中心项目、项目集群以及可能充当糖尿病困扰、抑郁症状和焦虑症状之间桥梁的项目。结果与方案相关和与医生相关的问题是糖尿病困扰网络中最核心(高度相关)和影响(最积极的联系)的问题之一。失败的抑郁症状被发现是抑郁和糖尿病困扰之间的潜在桥梁,与糖尿病困扰项目高度相关。过度担心、无法控制的担心和难以放松的焦虑症状分别被确定为连接焦虑和抑郁项目以及焦虑和糖尿病困扰项目的桥梁。结论 方案相关和医生相关的糖尿病特异性问题可能对糖尿病困扰的发展和维持很重要。失败和担忧的感觉是解释合并症的潜在强有力的候选者。
更新日期:2022-06-15
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