Emotional-volitional disorders in patients with type 2 diabetes mellitus, concomitant arterial hypertension and diabetic polyneuropathy
The objective of the present work was to evaluate effects of type 2 diabetes mellitus (DM2) combined with arterial hypertension (AH) and diabetic polyneuropathy (DPN) on the development of alterations in the emotional-volitional sphere. The work was comprised of two prospective studies; one of them (study 1) included 140 women presenting with DM2, the other (study 2) enrolled 80 patients with DM2 hospitalized at the Endocrinological Department of N.S. Karpovich City Clinical Hospital No 6, Krasnoyarsk. Disturbances in the emotional-volitional sphere were evaluated based on the hospital anxiety and depression scale (HADS). Their frequency proved to be as high as 67.9 and 70.7% in studies 1 and 2 respectively. The number of anxiety disorders was on the whole greater than that of depressive ones. The latter disorders in patients with AH occurred twice as often as in DM2 patients without AH (50.5 and 25.9% respectively). The frequency of anxiety disorders was not significantly different in the two groups, but they were found to be more severe in patients presenting with combination of DM2 and AH. It is concluded that DM2 is associated with frequent clinically significant anxiety and depressive symptoms depending on the duration of the disease and insulinotherapy. Patients presenting with a combination of DM2 and AH or DPN suffer significantly more pronounced anxiety and depression disordered.