Zusammenfassung
Hintergrund
Diabetesbezogener Stress und Depression sind wichtige psychosoziale Faktoren innerhalb der Diabetestherapie. Sie geben Aufschluss darüber, inwiefern sich der Diabetes und dessen Behandlung im Erleben der Betroffenen widerspiegeln.
Studienresultate
In verschiedenen Querschnittstudien fand sich eine starke Assoziation zwischen erhöhtem Stress durch die Diabeteserkrankung und depressiven Symptomen. Trotz dieser hohen korrelativen Übereinstimmung wurde in faktorenanalytischen Untersuchungen gezeigt, dass die beiden Konstrukte nicht austauschbar sind, sondern dass sich Symptome des diabetesbezogenen Stresses gut von depressiven Symptomen trennen lassen. In Längsschnittuntersuchungen wurde die Rolle des diabetesbezogenen Stresses als ätiologisch bedeutsamer Faktor für die Entstehung depressiver Symptome belegt. War er erhöht, nahm die Inzidenz gesteigerter depressiver Symptome um das 2,5-Fache zu. Darüber hinaus verdoppelte sich auch das Risiko für persistierend erhöhte depressive Symptome.
Therapeutische Konsequenzen
Oben angeführte Befunde zeigen deutlich, dass in Interventionsansätzen zur Reduktion depressiver Symptome bei Menschen mit Diabetes auch der diabetesbezogene Stress berücksichtigt werden muss. Entsprechende Interventionsstudien ergaben dementsprechend, dass durch seine Verminderung nicht nur die depressive Symptomatik, sondern auch die Inzidenz der klinischen Depression reduziert wurde. Für den klinischen Alltag steht daher mit dem diabetesbezogenen Stress ein krankheitsspezifisches Belastungsmaß zur Verfügung, welches Ansatzpunkte zur Optimierung der Diabetestherapie liefern und damit auch zur Prävention und Behandlung der depressiven Symptomatik beitragen kann.
Abstract
Background
Diabetes-related stress and depression are important psychosocial factors within diabetes therapy and are indicative of a patient’s perception of diabetes and its therapy.
Study results
Cross-sectional studies have demonstrated a strong association between diabetes and increased stress and depressive symptoms. Despite these high correlations, factor analysis has demonstrated that these two constructs are not interchangeable but that symptoms of stress can be separated from symptoms of depression. In longitudinal studies, the role of diabetes-related stress has been shown to be an aetiological factor for the development of depressive symptoms. Elevated levels of stress due to diabetes were associated with a 2.5-fold increase in the incidence of depressive symptoms. Similarly, the risk for persistent, elevated depressive symptoms was also doubled when diabetes-related distress was present.
Therapeutic consequences
Based on the above results, interventional measures to reduce depressive symptoms in people with diabetes should also incorporate diabetes-specific aspects. Interventional studies have found that by addressing and reducing diabetes-related stress that depressive symptoms are reduced and the incidence of major depression is lower. In clinical practice, diabetes-related stress can be used as a disease-specific indicator for optimizing diabetes therapy and can thus also contribute to the prevention and treatment of depressive symptoms.
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D. Ehrmann gibt an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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Ehrmann, D. Diabetesbezogener Stress und Depressivität. Diabetologe 13, 562–569 (2017). https://doi.org/10.1007/s11428-017-0277-8
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DOI: https://doi.org/10.1007/s11428-017-0277-8
Schlüsselwörter
- Diabetesassoziierte Komplikationen
- Depressive Symptome
- Schwere depressive Störung
- Interventionsstudien
- Längsschnittstudien