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在2型糖尿病(T2DM)患者中类似于抑郁症、焦虑症及糖尿病特异性情绪障碍等问题很常见,但却因经常未被认识而得不到治疗。针对这种情况,本综述集中讨论是否应该对糖尿病患者进行抑郁、焦虑、糖尿病特异性烦恼等筛查。目前,抑郁症得到了研究者们的关注。流行病学调查显示,10%～20%的T2DM患者伴随有抑郁症,但并未被人们普遍认识到。因此,一些指南推荐对T2DM患者定期进行情绪愉悦程度的评价。然而,这些指南没有强有力的循证医学证据,筛查对心理学和糖尿病最终结果的影响还缺乏随机对照研究来验证。针对非糖尿病患者的研究结果显示,对抑郁症的筛查没有改善结局。另一方面,对1型糖尿病(T1DM)或T2DM患者进行针对抑郁症的综合治疗似乎是有效的。当前,缺乏对糖尿病患者焦虑症干预性研究,而且也同样急切需要有助于优化抗抑郁治疗的前瞻性研究。
Problems similar to depression, anxiety and diabetes-specific mood disorders are common in patients with type 2 diabetes mellitus (T2DM), but are often left untreated because they are often unrecognized. In view of this situation, this review focuses on whether diabetes screening should be conducted on depression, anxiety and diabetes-specific distress. At present, depression has attracted the attention of researchers. Epidemiological survey showed that 10% to 20% of T2DM patients with depression, but has not been widely recognized. Therefore, some guidelines recommend the evaluation of emotional well-being in T2DM patients on a regular basis. However, these guidelines do not have strong evidence-based medical evidence, and the impact of screening on the final outcome of psychology and diabetes is lacking in randomized controlled trials. Results for non-diabetic patients show that screening for depression does not improve outcomes. On the other hand, a combination therapy for depression in patients with type 1 diabetes (T1DM) or T2DM appears to be effective. Currently, there is a lack of interventional studies on anxiety disorders in diabetic patients and there is an equally urgent need for prospective studies that will help optimize antidepressant treatment.