Författare/Namn
Titel Depression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types : : A cross sectional comparison
Anmärkning: Allmän
Anmärkning: Innehållsbeskrivning, sammanfattning Background: Increased prevalence of depression is found in both type 2 diabetes (T2D) and type 1 diabetes (T1D). Melancholia and atypical depression differ by cortisol secretion and clinical features. The aim was to compare the clinical presentation of T1D and T2D patients in relation to self-reported depression, self-reported anxiety, alexithymia, obesity, and midnight salivary cortisol (MSC). Methods: Comparative cross-sectional design. The participants were consecutively recruited from one hospital diabetes outpatient clinic: 24 T2D patients (31-59 years) and 148 T1D patients (32-59 years). Self-reported depression, anxiety and alexithymia were assessed by Hospital Anxiety and Depression scale and Toronto Alexithymia Scale-20. MSC, HbA1c, anthropometrics and data from medical records were collected. Multiple logistic regression analyses were performed. Results: Comparisons of prevalence between diabetes types showed for T2D/T1D: depression 25%/12% (P = 0.10); high MSC (≥9.3 nmol/L) 38%/22% (P = 0.13); alexithymia 25%/13% (P = 0.12); anxiety 38%/35% (P = 0.82). The prevalence of high MSC did not differ between depressed and non-depressed T2D patients (17% vs. 44%, P = 0.35), but differed between depressed and non-depressed T1D patients (53% vs. 18%, P = 0.003). The alexithymia prevalence differed between depressed and non-depressed T2D patients (67% vs.11%, P = 0.018), and between depressed and non-depressed T1D patients (47% vs. 11%, P < 0.001). The anxiety prevalence did not differ between depressed and non-depressed T2D patients (67% vs. 28%, P = 0.15), but differed between depressed and non-depressed T1D patients (76% vs. 30%, P < 0.001). The obesity prevalence (BMI ≥30 kg/m2) was 83% for depressed T2D patients and 6% for depressed T1D patients. In the T2D patients, depression was associated with alexithymia (Adjusted odds ratio (AOR) 15.0). In the T1D patients, depression was associated with anxiety (AOR 11.0), foot complications (AOR 8.5), HbA1C >70 mmol/mol (AOR 6.4), and high MSC (≥9.3 nmol/L) (AOR 4.8). Conclusions: The depressed T2D patients had traits of atypical depression, without associated high MSC (≥9.3 nmol/L) and anxiety, but the association with alexithymia was strong. The depressed T1D patients had traits of melancholia with associated high MSC and anxiety. The obesity prevalence was high in depressed T2D patients and low in depressed T1D patients.
Ämne
Medarbetare Thunander, Maria, Lunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Medicin, Lund, Medicine, Lund, Institutionen för kliniska vetenskaper, Malmö, Department of Clinical Sciences, Malmö, Genomik, diabetes och endokrinologi, Genomics, Diabetes and Endocrinology, Växjö Central Hospital Författare/medförfattare Landin-Olsson, Mona, Lunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Medicin, Lund, Medicine, Lund, Diabetes lab, Diabetes lab, Skåne University Hospital Författare/medförfattare Hillman, Magnus, Lunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Medicin, Lund, Medicine, Lund, Diabetes lab, Diabetes lab Författare/medförfattare Thulesius, Hans O., Lunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Malmö, Department of Clinical Sciences, Malmö, Allmänmedicin och samhällsmedicin, Family Medicine and Community Medicine, Region Kronoberg Författare/medförfattare Melin, Eva O Författare/medförfattare
Institutionsnamn
Värdpublikation BMC Psychiatry BioMed Central ISSN 1471-244X 17:1, s. 1-10 17:1<1-10
Elektronisk adress och åtkomst (URI) http://dx.doi.org/10.1186/s12888-017-1495-8 fulltext http://lup.lub.lu.se/record/9cf30cc6-aec5-4d4d-9191-851dafd09b99 Till lärosätets (lu) databas http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-81318 Till lärosätets (lnu) databas
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*1001 $aFÜRST MELIN, EVA,$uLunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Medicin, Lund, Medicine, Lund, Region Kronoberg$4aut$0(SwePub:lu)med-eme
*24510$aDepression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types : :$bA cross sectional comparison
*500 $aPublished
*500 $a5
*5203 $8eng$aBackground: Increased prevalence of depression is found in both type 2 diabetes (T2D) and type 1 diabetes (T1D). Melancholia and atypical depression differ by cortisol secretion and clinical features. The aim was to compare the clinical presentation of T1D and T2D patients in relation to self-reported depression, self-reported anxiety, alexithymia, obesity, and midnight salivary cortisol (MSC). Methods: Comparative cross-sectional design. The participants were consecutively recruited from one hospital diabetes outpatient clinic: 24 T2D patients (31-59 years) and 148 T1D patients (32-59 years). Self-reported depression, anxiety and alexithymia were assessed by Hospital Anxiety and Depression scale and Toronto Alexithymia Scale-20. MSC, HbA1c, anthropometrics and data from medical records were collected. Multiple logistic regression analyses were performed. Results: Comparisons of prevalence between diabetes types showed for T2D/T1D: depression 25%/12% (P = 0.10); high MSC (≥9.3 nmol/L) 38%/22% (P = 0.13); alexithymia 25%/13% (P = 0.12); anxiety 38%/35% (P = 0.82). The prevalence of high MSC did not differ between depressed and non-depressed T2D patients (17% vs. 44%, P = 0.35), but differed between depressed and non-depressed T1D patients (53% vs. 18%, P = 0.003). The alexithymia prevalence differed between depressed and non-depressed T2D patients (67% vs.11%, P = 0.018), and between depressed and non-depressed T1D patients (47% vs. 11%, P < 0.001). The anxiety prevalence did not differ between depressed and non-depressed T2D patients (67% vs. 28%, P = 0.15), but differed between depressed and non-depressed T1D patients (76% vs. 30%, P < 0.001). The obesity prevalence (BMI ≥30 kg/m2) was 83% for depressed T2D patients and 6% for depressed T1D patients. In the T2D patients, depression was associated with alexithymia (Adjusted odds ratio (AOR) 15.0). In the T1D patients, depression was associated with anxiety (AOR 11.0), foot complications (AOR 8.5), HbA1C >70 mmol/mol (AOR 6.4), and high MSC (≥9.3 nmol/L) (AOR 4.8). Conclusions: The depressed T2D patients had traits of atypical depression, without associated high MSC (≥9.3 nmol/L) and anxiety, but the association with alexithymia was strong. The depressed T1D patients had traits of melancholia with associated high MSC and anxiety. The obesity prevalence was high in depressed T2D patients and low in depressed T1D patients.
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*653 $aAlexithymia
*653 $aAnxiety
*653 $aCortisol
*653 $aDepression
*653 $aDiabetes Mellitus
*7001 $aThunander, Maria,$uLunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Medicin, Lund, Medicine, Lund, Institutionen för kliniska vetenskaper, Malmö, Department of Clinical Sciences, Malmö, Genomik, diabetes och endokrinologi, Genomics, Diabetes and Endocrinology, Växjö Central Hospital$4aut$0(SwePub:lu)med-mte
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*7001 $aHillman, Magnus,$uLunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Medicin, Lund, Medicine, Lund, Diabetes lab, Diabetes lab$4aut$0(SwePub:lu)med-mhi
*7001 $aThulesius, Hans O.,$uLunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Malmö, Department of Clinical Sciences, Malmö, Allmänmedicin och samhällsmedicin, Family Medicine and Community Medicine, Region Kronoberg$4aut$0(SwePub:lu)smi-hth
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