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Analysis of anxiety and depression status and influencing factors in diabetic patients with or without retinopathy

  • 1.

    Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China

  • 2.

    Department of Ophthalmology, Chaohu Hospital of Anhui Medical University, Hefei 243011, China

  • 3.

    Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 243011, China

Cite this:
https://doi.org/10.3969/j.issn.0253-2778.2020.03.017
  • Received Date: 19 December 2019
  • Accepted Date: 12 March 2020
  • Rev Recd Date: 12 March 2020
  • Publish Date: 31 March 2020
    Abstract

  • Abstract

    The aim of the present study was to explore the anxiety and depression status and influencing factors of diabetic patients with or without retinopathy. A total of 225 diabetic patients of Chaohu Hospital of Anhui Medical University were enrolled in the study, including 97 patients with retinopathy (diabetic retinopathy group, DR group) and 128 patients without retinopathy (non-diabetic retinopathy group, NDR group). The patient's general data were collected by questionnaire, and the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to assess the incidence and scores of anxiety and depression. The incidence and scores of anxiety and depression were compared between the two groups. The influencing factors of anxiety and depression status were evaluated. The results show that the incidence of anxiety and depression in DR group was higher than that in NDR group (anxiety: χ2=13.049, P<0.001; depression: χ2=13.049, P<0.001); and the scores of anxiety and depression in DR group were higher than those in NDR group (anxiety: t=-6.628, P<0.001; depression: t=-4.599, P<0.001). A univariate analysis reveals that gender, age, diabetes duration, monthly income, understanding of their own condition, understanding that diabetes can cause retinopathy, visual acuity, and ophthalmology were the influencing factors of anxiety scores in diabetic patients (t/F=-3.795, 4.364, -7.079, 5.213, 3.117, 4.702, 20.793, 5.087, P<0.05). Gender, diabets duration, monthly income, understanding that diabetes can cause retinopathy, visual acuity, and ophthalmology were the influencing factors of depression scores in diabetic patients (t/F=-2.363, -5.162, 3.844, -2.707, 12.638, -2.586, P<0.05). The results of multiple linear regression showed that gender, age, understanding of their condition, and visual acuity were the influencing factors of anxiety scores in diabetic patients. Gender and visual acuity were the influencing factors of depression score in diabetic patients. Patients with diabetic retinopathy have higher levels of anxiety and depression than those without retinopathy. Gender, age, time of diabetes, monthly income, understanding of their own condition, and visual acuity were the influencing factors of anxiety and depression scores in diabetic patients. It is necessary to give corresponding intervention to these factors so as to improve the quality of life of diabetic patients.

    Abstract

    The aim of the present study was to explore the anxiety and depression status and influencing factors of diabetic patients with or without retinopathy. A total of 225 diabetic patients of Chaohu Hospital of Anhui Medical University were enrolled in the study, including 97 patients with retinopathy (diabetic retinopathy group, DR group) and 128 patients without retinopathy (non-diabetic retinopathy group, NDR group). The patient's general data were collected by questionnaire, and the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to assess the incidence and scores of anxiety and depression. The incidence and scores of anxiety and depression were compared between the two groups. The influencing factors of anxiety and depression status were evaluated. The results show that the incidence of anxiety and depression in DR group was higher than that in NDR group (anxiety: χ2=13.049, P<0.001; depression: χ2=13.049, P<0.001); and the scores of anxiety and depression in DR group were higher than those in NDR group (anxiety: t=-6.628, P<0.001; depression: t=-4.599, P<0.001). A univariate analysis reveals that gender, age, diabetes duration, monthly income, understanding of their own condition, understanding that diabetes can cause retinopathy, visual acuity, and ophthalmology were the influencing factors of anxiety scores in diabetic patients (t/F=-3.795, 4.364, -7.079, 5.213, 3.117, 4.702, 20.793, 5.087, P<0.05). Gender, diabets duration, monthly income, understanding that diabetes can cause retinopathy, visual acuity, and ophthalmology were the influencing factors of depression scores in diabetic patients (t/F=-2.363, -5.162, 3.844, -2.707, 12.638, -2.586, P<0.05). The results of multiple linear regression showed that gender, age, understanding of their condition, and visual acuity were the influencing factors of anxiety scores in diabetic patients. Gender and visual acuity were the influencing factors of depression score in diabetic patients. Patients with diabetic retinopathy have higher levels of anxiety and depression than those without retinopathy. Gender, age, time of diabetes, monthly income, understanding of their own condition, and visual acuity were the influencing factors of anxiety and depression scores in diabetic patients. It is necessary to give corresponding intervention to these factors so as to improve the quality of life of diabetic patients.
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    • References(27)
  • [1]
    GRIGSBY A B, ANDERSON R J, FREEDLAND K E, et al. Prevalence of anxiety in adults with diabetes: A systematic review [J]. Journal of Psychosomatic Research, 2002, 53(6):1053-1060.
    [2]
    DOVE A E, MARATHE P H, GAO H X, et al. Diabetes News [J]. Journal of Diabetes, 2017, 9(2):111-114.
    [3]
    HENG L Z, COMYN O, PETO T, et al. Diabetic retinopathy: pathogenesis, clinical grading, management and future developments [J]. Diabetic Medicine, 2013, 30(6):640-650.
    [4]
    REES G, XIE J, FENWICK E K, et al. Association between diabetes-related eye complications and symptoms of anxiety and depression [J]. JAMA Ophthalmology, 2016, 134(9):1007-1014.
    [5]
    曾奎, 马林昆, 曹霞, et al. 有无视网膜病变的糖尿病患者焦虑、抑郁状态及人格特征比较[J]. 中华眼底病杂志, 2015, 31(2):130-133.
    ZENG Kui，MA Linkun，CAO Xia. Comparative analysis of anxiety，depression and personality characteristics between diabetic patients with or without diabetes retinopathy[J].Chinese Journal of Ocular Fundus Diseases, 2015, 31(2):130-133.
    [6]
    中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年)[J]. 中华眼科杂志, 2014, 50(11):851-865.
    [7]
    COLLINS M M, CORCORAN P, PERRY I J. Anxiety and depression symptoms in patients with diabetes [J]. Diabetic Medicine, 2009, 26(2):153-161.
    [8]
    KHUWAJA A K, LALANI S, DHANANI R, et al. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors [J]. Diabetology & Metabolic Syndrome, 2010, 2:72.
    [9]
    MASMOUDI J, DAMAK R, ZOUARI H, et al. Prevalence and impact of anxiety and depression on Type 2 diabetes in Tunisian patients over sixty years old [J]. Depression Research and Treatment , 2013, 2013:341782.
    [10]
    HUANG Y Q, WANG Y, WANG H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study [J]. Lancet Psychiatry, 2019, 6(3): 211-224.
    [11]
    SEMENKOVICH K, BROWN M E, SVRAKIC D M, et al. Depression in type 2 diabetes mellitus: prevalence, impact, and treatment [J]. Drugs, 2015, 75(6):577-587.
    [12]
    KAWADA T. Anxiety symptoms and functioning in patients with type 2 diabetes [J]. Journal of Diabetes, 2017, 9(6):634.
    [13]
    TRACEY M L, MCHUGH S M, FITZGERALD A P, et al. Trends in blindness due to diabetic retinopathy among adults aged 18-69 years over a decade in Ireland [J]. Diabetes Research and Clinical Practice, 2016, 121:1-8.
    [14]
    TRENTO M, TPMELINI M, LATTANZIO R, et al. Perception of, and anxiety levels induced by, laser treatment in patients with sight-threatening diabetic retinopathy [J]. A multicentre study [J]. Diabetic Medicine, 2006, 23(10):1106-1109.
    [15]
    杨丽, 王琴. 糖尿病视网膜病变患者行玻璃体切割术围术期焦虑、抑郁及影响因素[J]. 中国临床心理学杂志, 2016, 24(1):152-154.
    YANG Li, WANG Qin. Anxiety, depresstion and their risk factors during vitrectomy in patients with diabetic retinopathy[J]. Chinese Journal of Clinical Psychology, 2016, 24(1):152-154.
    [16]
    BRITO P N, ROSAS V M, COENTRAO L M, et al. Evaluation of visual acuity, macular status, and subfoveal choroidal thickness changes after cataract surgery in eyes with diabetic retinopathy [J]. Retina. 2015, 35(2):294-302.
    [17]
    TU Y, XU L, WEI W B, et al. Progression of diabetic retinopathy: The Beijing Eye Study [J]. Chinese Medical Journal, 2011, 124(22):3635-3640.
    [18]
    CAMPAYO A, GOMEZ-BIEL C H, LOBO A. Diabetes and depression [J]. Current Psychiatry Reports. 2011, 13(1):26-30.
    [19]
    严茂,袁丽. 糖尿病患者抑郁焦虑现状调查与分析[J]. 中华现代护理杂志, 2016, 22(8):1086-1089.
    YAN Mao,YUAN Li.Investigation and analysis of depression and anxiety in diabetic patients[J].Chinese Journal of Modern Nursing, 2016, 22(8): 1086-1089.
    [20]
    MYPRAKU A, ROBAKIS T, RASGON N. Estrogen-Based Hormone Therapy for Depression Related to Reproductive Events [J]. Current Treatment Options in Psychiatry, 2018, 5(4):416-424.
    [21]
    SHARMA V, DOOBAY M, BACZYNSKI C. Bipolar postpartum depression: An update and recommendations [J]. Journal of Affective Disorders, 2017, 219:105-111.
    [22]
    BRYANT C, JUDD F K, HICKEY M. Anxiety during the menopausal transition: a systematic review [J]. Journal of Affective Disorders, 2012, 139(2):141-148.
    [23]
    SATYANARAYANA V A, CHANDRA P S, VADDIPARTI K. Mental health consequences of violence against women and girls [J]. Current Opinion in Psychiatry, 2015, 28(5):350-356.
    [24]
    FLORES-RAMOS M, SILVESTRI TOMASSONI R, GUERRERO-LOPEZ J B, et al. Evaluation of trait and state anxiety levels in a group of peri- and postmenopausal women [J]. Women Health, 2018, 58(3):305-319.
    [25]
    钱湘毅, 王海琴. 社区2型糖尿病患者抑郁和焦虑情绪危险因素流行病学调查[J]. 中国现代药物应用, 2011, 5(22):132-134.
    QIAN Xiangyi, WANG Haiqin. Epidemiological investigation of risk factors for depression and anxiety in community type 2 diabetic patients[J].Chinese journal of modern drug application, 2011, 5(22):132-134.
    [26]
    WALLACE K, ZHAO X, MISRA R, et al. The Humanistic and Economic Burden Associated with Anxiety and Depression among Adults with Comorbid Diabetes and Hypertension [J]. Journal of Diabetes Research, 2018, 2018:4842520.
    [27]
    REUS G Z, CARLESSI A S, SILVA R H, et al. Relationship of Oxidative Stress as a Link between Diabetes Mellitus and Major Depressive Disorder [J]. Oxidative Medicine and Cellular Longevity, 2019, 2019:8637970.
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    [1]
    GRIGSBY A B, ANDERSON R J, FREEDLAND K E, et al. Prevalence of anxiety in adults with diabetes: A systematic review [J]. Journal of Psychosomatic Research, 2002, 53(6):1053-1060.
    [2]
    DOVE A E, MARATHE P H, GAO H X, et al. Diabetes News [J]. Journal of Diabetes, 2017, 9(2):111-114.
    [3]
    HENG L Z, COMYN O, PETO T, et al. Diabetic retinopathy: pathogenesis, clinical grading, management and future developments [J]. Diabetic Medicine, 2013, 30(6):640-650.
    [4]
    REES G, XIE J, FENWICK E K, et al. Association between diabetes-related eye complications and symptoms of anxiety and depression [J]. JAMA Ophthalmology, 2016, 134(9):1007-1014.
    [5]
    曾奎, 马林昆, 曹霞, et al. 有无视网膜病变的糖尿病患者焦虑、抑郁状态及人格特征比较[J]. 中华眼底病杂志, 2015, 31(2):130-133.
    ZENG Kui，MA Linkun，CAO Xia. Comparative analysis of anxiety，depression and personality characteristics between diabetic patients with or without diabetes retinopathy[J].Chinese Journal of Ocular Fundus Diseases, 2015, 31(2):130-133.
    [6]
    中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年)[J]. 中华眼科杂志, 2014, 50(11):851-865.
    [7]
    COLLINS M M, CORCORAN P, PERRY I J. Anxiety and depression symptoms in patients with diabetes [J]. Diabetic Medicine, 2009, 26(2):153-161.
    [8]
    KHUWAJA A K, LALANI S, DHANANI R, et al. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors [J]. Diabetology & Metabolic Syndrome, 2010, 2:72.
    [9]
    MASMOUDI J, DAMAK R, ZOUARI H, et al. Prevalence and impact of anxiety and depression on Type 2 diabetes in Tunisian patients over sixty years old [J]. Depression Research and Treatment , 2013, 2013:341782.
    [10]
    HUANG Y Q, WANG Y, WANG H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study [J]. Lancet Psychiatry, 2019, 6(3): 211-224.
    [11]
    SEMENKOVICH K, BROWN M E, SVRAKIC D M, et al. Depression in type 2 diabetes mellitus: prevalence, impact, and treatment [J]. Drugs, 2015, 75(6):577-587.
    [12]
    KAWADA T. Anxiety symptoms and functioning in patients with type 2 diabetes [J]. Journal of Diabetes, 2017, 9(6):634.
    [13]
    TRACEY M L, MCHUGH S M, FITZGERALD A P, et al. Trends in blindness due to diabetic retinopathy among adults aged 18-69 years over a decade in Ireland [J]. Diabetes Research and Clinical Practice, 2016, 121:1-8.
    [14]
    TRENTO M, TPMELINI M, LATTANZIO R, et al. Perception of, and anxiety levels induced by, laser treatment in patients with sight-threatening diabetic retinopathy [J]. A multicentre study [J]. Diabetic Medicine, 2006, 23(10):1106-1109.
    [15]
    杨丽, 王琴. 糖尿病视网膜病变患者行玻璃体切割术围术期焦虑、抑郁及影响因素[J]. 中国临床心理学杂志, 2016, 24(1):152-154.
    YANG Li, WANG Qin. Anxiety, depresstion and their risk factors during vitrectomy in patients with diabetic retinopathy[J]. Chinese Journal of Clinical Psychology, 2016, 24(1):152-154.
    [16]
    BRITO P N, ROSAS V M, COENTRAO L M, et al. Evaluation of visual acuity, macular status, and subfoveal choroidal thickness changes after cataract surgery in eyes with diabetic retinopathy [J]. Retina. 2015, 35(2):294-302.
    [17]
    TU Y, XU L, WEI W B, et al. Progression of diabetic retinopathy: The Beijing Eye Study [J]. Chinese Medical Journal, 2011, 124(22):3635-3640.
    [18]
    CAMPAYO A, GOMEZ-BIEL C H, LOBO A. Diabetes and depression [J]. Current Psychiatry Reports. 2011, 13(1):26-30.
    [19]
    严茂,袁丽. 糖尿病患者抑郁焦虑现状调查与分析[J]. 中华现代护理杂志, 2016, 22(8):1086-1089.
    YAN Mao,YUAN Li.Investigation and analysis of depression and anxiety in diabetic patients[J].Chinese Journal of Modern Nursing, 2016, 22(8): 1086-1089.
    [20]
    MYPRAKU A, ROBAKIS T, RASGON N. Estrogen-Based Hormone Therapy for Depression Related to Reproductive Events [J]. Current Treatment Options in Psychiatry, 2018, 5(4):416-424.
    [21]
    SHARMA V, DOOBAY M, BACZYNSKI C. Bipolar postpartum depression: An update and recommendations [J]. Journal of Affective Disorders, 2017, 219:105-111.
    [22]
    BRYANT C, JUDD F K, HICKEY M. Anxiety during the menopausal transition: a systematic review [J]. Journal of Affective Disorders, 2012, 139(2):141-148.
    [23]
    SATYANARAYANA V A, CHANDRA P S, VADDIPARTI K. Mental health consequences of violence against women and girls [J]. Current Opinion in Psychiatry, 2015, 28(5):350-356.
    [24]
    FLORES-RAMOS M, SILVESTRI TOMASSONI R, GUERRERO-LOPEZ J B, et al. Evaluation of trait and state anxiety levels in a group of peri- and postmenopausal women [J]. Women Health, 2018, 58(3):305-319.
    [25]
    钱湘毅, 王海琴. 社区2型糖尿病患者抑郁和焦虑情绪危险因素流行病学调查[J]. 中国现代药物应用, 2011, 5(22):132-134.
    QIAN Xiangyi, WANG Haiqin. Epidemiological investigation of risk factors for depression and anxiety in community type 2 diabetic patients[J].Chinese journal of modern drug application, 2011, 5(22):132-134.
    [26]
    WALLACE K, ZHAO X, MISRA R, et al. The Humanistic and Economic Burden Associated with Anxiety and Depression among Adults with Comorbid Diabetes and Hypertension [J]. Journal of Diabetes Research, 2018, 2018:4842520.
    [27]
    REUS G Z, CARLESSI A S, SILVA R H, et al. Relationship of Oxidative Stress as a Link between Diabetes Mellitus and Major Depressive Disorder [J]. Oxidative Medicine and Cellular Longevity, 2019, 2019:8637970.
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