糖尿病病人憂鬱症之評估與處置

糖尿病佔國人十大死因第五位，易併發其他慢性疾病，不僅威脅個案的生命，且造成很大家庭及社會之負擔。糖尿病患者罹病過程大部分會經歷一連串心理衝擊，如糖尿病病患常伴隨發生憂鬱，其盛行率大約是一般族群的兩倍或更多。本文主旨為探討憂鬱影響糖尿病疾病控制，首先以文獻查證方式整理糖尿病與憂鬱症發生率、產生機轉及對糖尿病病患之不良影響；接著介紹數種常用於糖尿病病人之憂鬱量表，提供給臨床照護人員參考，以利於具體評估與轉介。接著，簡介糖尿病憂鬱的處置；最後，從病人、醫護人員和研究層面提出具體的建議。

Diabetes is in the fifth place among the top ten leading causes of death in Taiwan, and it is frequently accompanied by other chronic diseases. Diabetes not only menaces patients' life, but also is a heavy burden to family and society. During the disease process, most of the patients with diabetes will experience a series of psychological impacts. For example, patients with diabetes frequently experience depression, and its prevalence rate is two times (or more) higher than that of general patients. In order to investigate how depression affects disease control of diabetes, this study conducted literature review to summarize the incidence of diabetes and depression, pathogenesis, and adverse effects of depression on patients with diabetes. It also summarized several depression scales commonly used in patients with diabetes. We hope that this review could serve as references for clinical caregivers to facilitate the specific evaluation and referral, introduction intervention of depression on patients with diabetes. Furthermore, we also proposed specific suggestions on the aspects of patients, medical and nursing personnel, and research.