Zaporožskij Medicinskij Žurnal (Apr 2017)
Structure of comorbid psychopathological disorders in patients with type 2nd diabetes mellitus
Abstract
Aim: to identify and explore the structure of comorbid psychopathological disorders in patients with type 2nd diabetes mellitus (DM). Materials and methods: 543 patients with type 2nd DM were included into the study. The average age of patients was (56.2 ± 0.65) years. The patients were divided into three groups according to the severity of DM. The first clinical group (CG-1) included 57 patients with type 2nd DM of mild severity, who was treated in outpatient department; the average age in the group was (51.8 ± 1.28) years. The second clinical group (CG-2) made up of 312 patients with type 2nd DM, moderate severity, they were in inpatient department; the median age of the group was (55.1 ± 1.12) years. The third clinical group (CG-3) included 174 patients with type 2nd DM, severe degrees of severity, they undergone inpatient treatment too; average age in the group was (61.8 ± 0.85) years. Research methods: clinical-anamnesis, clinical- psychopathological, statistical. Research results. The study established the incidence of non-psychotic mental disorders of varying severity in patients with type 2nd DM at the level of 94.11 %, among them, for 91.16 % – of psychogenic origin. Proportional correlation between the severity of type 2nd DM and the absence of comorbid psychopathological manifestations was detected (rs = -0.3416, p < 0.01). It is revealed that the dominant psychopathological syndromes among all patients with type 2nd DM were psychoorganic (62.43 %), dyssomnia (60.86 %), asthenic (55.58 %) and anxiety (43.05 %) syndromes. Structure of the dominant psychopathological syndromes was established depending on severity of type 2nd DM: in CG-1 dominated dyssomnia (36.84 %), anxiety (31.58 %), psychoorganic (21.05 %) syndromes; in CG-2 – psychoorganic (65.38 %), asthenic (40.38 %), dyssomnia (38.46 %), anxiety (37, and 82 %) syndromes; in CG-3 – dyssomnia (97.70 %), asthenic (89.08 %), organic mental (70.69 %), anxious 48.28 %) syndromes. Significant prevalence among all study groups was detected for hysterical (χ2 = 13.416, p < 0.01) and phobic syndromes (χ2 = 6.161, p < 0.05) in g CG-1 compared to CG-2 and CG-3; and asthenia (χ2 = 162.663, p < 0.01), anxiety (χ2 = 7.177, p < 0.05), depression (χ2 = 13.298, p < 0.01), dyssomnia (χ2 = 171.058, p < 0.01), hypochondric (χ2 = 19.331, p < 0.01), psychoorganic (χ2 = 47.830, p < 0.01) syndromes in CG-3 compared to CG-1 and CG-2. Direct correlation between the severity of type 2nd DM and the presence of the clinical picture asthenic (rs = 0.4033, p < 0.01) and psychoorganic (rs = 0.2344, p < 0.01) syndromes was identified; and inverse correlation between the severity of type 2nd DM and the presence of the clinical manifestation of patients with hysterical syndrome (rs = -0.1444, p < 0.01). Conclusion. The study established the frequency of occurrence and genesis of nonpsychotic mental disorders of varying severity in patients with type 2 DM. Correlation between the severity of type 2nd DM and comorbid psychopathological symptoms was revealed. The identified dominant psychopathological syndromes among patients with type 2nd DM, as well as the structure of psychopathological disorders depended on the severity of type 2nd DM.
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