Mental disorders in patients with osteoarthritis combined with diabetes mellitus in the practice of a family doctor
Notice bibliographique
Résumé
Background. Osteoarthritis is a chronic degenerative joint disease, often accompanied by pain, limited mobility and reduced quality of life. Diabetes mellitus, in turn, is a metabolic disease with systemic complications. The coexistence of these two pathologies is a frequent clinical phenomenon that aggravates the course of each disease. The purpose of the study was to assess the level of mental health in patients with osteoarthritis who have concomitant diabetes mellitus, to identify the main psycho-emotional disorders and develop recommendations for the diagnosis, treatment, prevention and improvement of psychosocial support for such people. Materials and methods. The study included 120 patients who were divided into three groups: group I — osteoarthritis without concomitant type 2 diabetes mellitus (T2DM); group II — T2DM without osteoarthritis; group III — comorbidity of osteoarthritis and T2DM. The following research methods were used: the Hospital Anxiety and Depression Scale (HADS) — to identify anxiety and depressive symptoms; Beck Depression Inventory-II — to quantify the level of depression; SF-36 Health Survey — to analyze quality of life, in particular mental and physical components; Mini-Mental State Examination (MMSE) — to screen for cognitive disorders; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) — to assess the severity of pain syndrome, stiffness and functional limitation. Results. Among patients with osteoarthritis (group I), clinically significant manifestations of depression (> 11 points on the HADS) were detected in 32.5 % of cases, anxiety — in 40 %. Among patients with T2DM (group II), depression — in 27.5 %, anxiety — in 35 %. The highest level of depressive and anxiety manifestations was observed in patients with comorbidity of osteoarthritis and T2DM (group III): depression — 55 %, anxiety — 60 %. According to the MMSE, mild cognitive impairment was detected in 15 % of patients from group I, 22.5 % from group II and 37.5 % from group III. Patients with comorbidity of osteoarthritis and T2DM demonstrated the worst indicators of physical functioning and mental health according to the SF-36 scale. Decreased quality of life was mainly associated with pain syndrome, mobility limitation and emotional exhaustion. A positive correlation was established between the level of glycated hemoglobin and the severity of depression (r = 0.42; p < 0.01). A relationship was also found between the severity of pain syndrome (WOMAC) and the level of anxiety (r = 0.51; p < 0.01). The statistical power of the analysis of variance with a sample of 120 patients (3 groups of 40 patients) and a moderately high effect (f = 0.35) is 93.4 %. This indicates a high probability of detecting real intergroup differences, i.e. the sample size is statistically justified for the stated study design. Conclusions. Comorbid course of osteoarthritis and type 2 diabetes is associated with a high risk of developing depressive and anxiety disorders, which significantly reduces the quality of life of patients and requires not only medical, but also psychological support. Depressive symptoms correlate with the intensity of pain and impaired metabolic control, which complicates the overall clinical course of diseases. Socio-psychological factors (stress, loneliness) play an important role in the formation of psycho-emotional disorders in patients with comorbidity.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».