2011 Volume 51 Issue 10 Pages 902-909
Background: A medical psychologist, evaluating Baumtest (tree-drawing test) of diabetic inpatients, noted interruption of the "trunk", which is normally drawn as a single line, and its continuation with an additional line. We defined this pattern as "Intermittent trunk". To clarify the clinical usefulness of the indicator "Intermittent trunk" on Baumtest in diabetics, we examined the psychological and clinical characteristics of the diabetic inpatients. Method: Subjects were 58 diabetic inpatients (men/women=32/26; mean age at admission=66.3±10.8 years; BMI=24.9±4.6; HbA1c=9.7±2.3%). A clinical psychologist, conducting interviews for psychosocial information, examined Baumtest and questionnaires for Probrem Area In Diabetes Survey (PAID), the Dietary Distress Scale, and Self-rating Depression Scale. Results: The total scores of PAID obtained from women were significantly higher than those from men (34.0±9.2 vs. 29.1±6.0, respectively, p<0.05). The Dietary Distress Scale (26.5±5.7) and Self-rating Depression Scale (28.9±6.4) showed no differences between men and women. The total scores of PAID were significantly correlated with both the Dietary Distress Scale (r_s=0.62, p=9.880E-08) and duration of illness (r_s=0.32, p=0.00658). However, the total scores of PAID were not related to HbA1c. The subjects were divided into three groups: a group without "Intermittent trunk" (n=29), an "Intermittent trunk" group (n=15), and modified "Intermittent trunk" group (n=14). The total scores of three questionnaires (PAID, the Dietary Distress Scale, and Self-rating Depression Scale) were not high and showed no differences between the three groups. On the other hand, a Sex difference was found between the "Intermittent trunk" and modified "Intermittent trunk" groups (Yates Chi=9.323, p=0.009). The Modified "Intermittent trunk" group showed a significant decrease in both the fasting and postprandial C-peptide levels, analyzed using the Kruskal-Wallis test (fasting: H=7.494, p<0.05, postprandial; H=9.07, p<0.01). "Intermittent trunk" group also showed the same tendency toward a decrease in endogenous insulin secretion. Conclusion: In diabetic patients, the indicator "Intermittent trunk" on Baumtest, which is a non-verbal projective method, might be an aid of psycho diagnosis beyond assessment using the questionnaires of PAID, the Dietary Distress Scale, and Self-rating Depression Scale.
