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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。
Objective: To investigate the causes and characteristics of somatic symptoms in patients with diabetes mellitus and depression under Chinese culture background. Methods: One hundred and fourty-seven patients with type 2 diabetes mellitus were selected for convenience in hospitalization. The depressive status and somatic symptom index (SSI) were used to assess the somatic symptoms by using the scale of depression center (CES-D) ) To assess the adverse emotions associated with diabetes, parallel one-way correlation analysis and multiple linear regression analysis. Results: 24.8% of the patients in the depression group were depressed. The scores of DDS, SSI and somatic symptoms in depression group were higher than those without depression. The SSI score was negatively correlated with the education level (r = -0.216, P = 0.011 ) Was significantly correlated with the complication (r = 0.225, P = 0.008). The correlation between the CES-D score (r = 0.191, P = 0.025) r = 0.466, P <0.001). The total score of DDS (r = 0.392, P <0.001) was positively correlated. Multivariate linear regression analysis revealed a total CES-D score, DDS total score, and complication rates that accounted for 39.1% of the total SSI variation (P <0.001). Conclusion: Patients with diabetes mellitus and depression have more somatic symptoms in Chinese culture. There is overlap between somatic symptoms of diabetes and somatization of depression. The main symptom of somatic symptoms is an important clue to identify depression.