[Mental disorders in type 2 diabetes]. / Psikhicheskie rasstroistva pri sakharnom diabete 2-go tipa.

OBJECTIVE: To assess the prevalence of mental disorders in patients with type 2 diabetes mellitus (DM2) and their relationship with laboratory findings, somatic comorbidities and psychosocial consequences. MATERIAL AND METHODS: In the frames of the INTERPRET-DD multicenter 200 T2DM patients from primary care (47 men and 153 women) from the Russian sample were studied. The psychometric assessment included MINI-6, HAMD-17, PHQ-9, PAID, WHO-5. RESULTS: One hundred and seventeen patients (58.5%) have mental disorders. Current mental disorders were diagnosed in 93 (46.5%) of patients. Depression (depressive episode, recurrent depressive disorder, bipolar affective disorder type II) was identified in 34 (17.0%), dysthymia in 26 (13.0%), and anxiety spectrum disorders in 39 (19.5%). In about half of the cases, anxiety disorders were combined with depression. The most severe problems were observed in the patients with depression and dysthymia. Patients with social phobia had significantly higher levels of glycated hemoglobin compared to patients without mental disorders. The significant decrease of systolic arterial pressure and body mass index was observed in patients with agoraphobia compared to patients without mental disorders. In addition, there was an increased prevalence of chronic ischemic heart disease in recurrent depression, dysthymia and generalized anxiety disorder, higher prevalence of neuropathy in depressive episode and recurrent depression and nephropathy in panic disorder. CONCLUSION: Depressive and anxiety disorders, as well as severe psychosocial problems, are consistently associated with T2DM. At the same time, concomitant somatic disorders and complications of DM2 are not just by chance comorbid to various forms of mental disorders, which allows for a new look at the problem of comorbidity/multimorbidity in T2DM.

[Anxiety-depressive disorders and cognitive impairment in patients of the primary level of health care].

An objective of the study was to compare cognitive and anxiety-depressive disorders in patients of the primary level of health care. Authors studied 103 patients, mean age 51.2±15.9 years, of a psychotherapeutic setting in a polyclinic. Patients were stratified into three groups: patients with anxiety-depressive disorders (ADD), with mild organic mental disorders (MOMD) and with the combination of ADD and MOMD. Patients were assessed using a form for assessment of anxiety and depressive symptoms and psychometric scales HADS, MMSE, FAB, ACE-R. High positive correlations between the total score on the subscale "depression" of the HADS and some ACE-R items (total score, orientation/attention, verbal fluency) and total score on the FAB were identified in patients with ADD and MOMD compared to other groups. In patients with ADD, the correlations between some measures of cognitive style and language disturbances measured with the ACE-R were found. The results indicate that it is necessary to evaluate cognitive impairment (deficit symptoms and distortions in cognitive styles) in patients with anxiety-depressive disorders at the primary level of health care and to take it in account in choosing treatment options and predicting outcome.