Depression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types: a cross sectional comparison

BMC Psychiatry

Research Article

Hans O. Thulesius¹  Magnus Hillman²  Mona Landin-Olsson³  Maria Thunander⁴  Eva O. Melin⁵ 

[1] Department of Research and Development, Box 1223, Region Kronoberg, SE-351 12, Växjö, Sweden;Primary Care, Region Kronoberg, Växjö, Sweden;Family Medicine, Department of Clinical Sciences, Lund University, Malmoe, Sweden;Diabetes Research Laboratory BMC, Lund University, Lund, Sweden;Endocrinology and Diabetes, Department of Clinical Sciences, Lund University, Lund, Sweden;Department of Endocrinology, Lund University Hospital, Lund, Sweden;Endocrinology and Diabetes, Department of Clinical Sciences, Lund University, Lund, Sweden;Department of Research and Development, Box 1223, Region Kronoberg, SE-351 12, Växjö, Sweden;Department of Internal Medicine, Central Hospital, Region Kronoberg, Växjö, Sweden;Endocrinology and Diabetes, Department of Clinical Sciences, Lund University, Lund, Sweden;Department of Research and Development, Box 1223, Region Kronoberg, SE-351 12, Växjö, Sweden;Primary Care, Region Kronoberg, Växjö, Sweden;

关键词: Alexithymia;    Anxiety;    Depression;    Cortisol;    Diabetes mellitus;   

DOI  :  10.1186/s12888-017-1495-8

 received in 2016-10-13, accepted in 2017-09-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIncreased 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).MethodsComparative 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.ResultsComparisons 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).ConclusionsThe 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.

【 授权许可】

CC BY   
© The Author(s). 2017