title: Comorbidity of psychiatric disorders and symmetric distal polyneuropathy among type II diabetic outpatients.
abstract: The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8%). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 +/- 1.97 vs 7.48 +/- 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0%; P = 0.01), and major depression--current episode, in particular (18.2 vs 7.7%; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.
authors.affiliation: Unidade de Psiconeuroendocrinologia, Instituto Estadual de Diabetes e Endocrinologia/Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rua Moncorvo Filho 90, 20211-340 Rio de Janeiro, RJ, Brazil. rom_br@yahoo.com
authors.forename: R O
authors.initials: RO
authors.lastname: Moreira
authors.forename: M
authors.initials: M
authors.lastname: Papelbaum
authors.forename: L F
authors.initials: LF
authors.lastname: Fontenelle
authors.forename: J C
authors.initials: JC
authors.lastname: Appolinario
authors.forename: V C M
authors.initials: VC
authors.lastname: Ellinger
authors.forename: W F
authors.initials: WF
authors.lastname: Coutinho
authors.forename: L
authors.initials: L
authors.lastname: Zagury
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D011115:Polyneuropathies / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012959:Socioeconomic Factors