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Byeon H. Developing a nomogram for predicting depression in diabetic patients after COVID-19 using machine learning. Front Public Health 2023; 11:1150818. [PMID: 37533521 PMCID: PMC10390766 DOI: 10.3389/fpubh.2023.1150818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/10/2023] [Indexed: 08/04/2023] Open
Abstract
Objective This study identified major risk factors for depression in community diabetic patients using machine learning techniques and developed predictive models for predicting the high-risk group for depression in diabetic patients based on multiple risk factors. Methods This study analyzed 26,829 adults living in the community who were diagnosed with diabetes by a doctor. The prevalence of a depressive disorder was the dependent variable in this study. This study developed a model for predicting diabetic depression using multiple logistic regression, which corrected all confounding factors in order to identify the relationship (influence) of predictive factors for diabetic depression by entering the top nine variables with high importance, which were identified in CatBoost. Results The prevalence of depression was 22.4% (n = 6,001). This study calculated the importance of factors related to depression in diabetic patients living in South Korean community using CatBoost to find that the top nine variables with high importance were gender, smoking status, changes in drinking before and after the COVID-19 pandemic, changes in smoking before and after the COVID-19 pandemic, subjective health, concern about economic loss due to the COVID-19 pandemic, changes in sleeping hours due to the COVID-19 pandemic, economic activity, and the number of people you can ask for help in a disaster situation such as COVID-19 infection. Conclusion It is necessary to identify the high-risk group for diabetes and depression at an early stage, while considering multiple risk factors, and to seek a personalized psychological support system at the primary medical level, which can improve their mental health.
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Affiliation(s)
- Haewon Byeon
- Department of Digital Anti-aging Healthcare (BK21), Graduate School of Inje University, Gimhae, Republic of Korea
- Department of Medical Big Data, College of AI Convergence, Inje University, Gimhae, Republic of Korea
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Denche-Zamorano A, Perez-Gomez J, Barrios-Fernandez S, Oliveira R, Adsuar JC, Brito JP. Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2857. [PMID: 36833555 PMCID: PMC9958756 DOI: 10.3390/ijerph20042857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.
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Affiliation(s)
- Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Perez-Gomez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Jose C. Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
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Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019; 56:631-650. [PMID: 30903433 DOI: 10.1007/s00592-019-01295-9] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
AIMS Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. METHODS MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". RESULTS In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). CONCLUSION Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.
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Affiliation(s)
- Mohammad Khaledi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Wang D, Shi L, Li L, Guo X, Li Y, Xu Y, Yin S, Wu Q, Yang Y, Zhuang X, Gai Y, Li Q, Liu Y. Subthreshold depression among diabetes patients in Beijing: Cross-sectional associations among sociodemographic, clinical, and behavior factors. J Affect Disord 2018; 237:80-86. [PMID: 29793084 DOI: 10.1016/j.jad.2018.05.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 04/05/2018] [Accepted: 05/15/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study explores the prevalence of subthreshold depression (SubD) and its association with factors in type 2 diabetes mellitus (T2DM) patients. METHODS This cross-sectional study involved 808 outpatients with T2DM from ten hospitals in Beijing between September 2015 and January 2016. All participants completed the Patient Health Questionnaire 9-item (PHQ-9) to evaluate depressive status, with scores between 5 and 14 considered SubD. Conditional logistic regression was conducted to investigate the variables associated with SubD in T2DM patients. RESULTS T2DM patients with SubD comprised 11.6% (n = 94) of the sample. The odd ratios for the variables having significant positive associations with SubD were: being a women (OR = 1.90; 95%CI: 1.09-3.32), divorced/widowed (OR = 3.27; 95%CI: 1.46-7.30), comorbidity of cerebrovascular disease (OR = 2.00; 95%CI: 1.06-3.76), more diabetic complications (OR = 8.04; 95%CI: 2.77-23.31), and higher HbA1c in men (OR = 2.41; 95%CI: 1.25-4.64). Being older (OR = 0.78; 95%CI: 0.62-0.98), exercising more (OR = 0.44; 95%CI: 0.22-0.91) and poverty (OR = 0.36; 95%CI: 0.19-0.69) were negatively related to SubD. LIMITATIONS The sample was mainly recruited from hospital settings, which limits generalization. The study's cross-sectional design precludes making causal inferences. CONCLUSIONS The proportion of SubD was estimated to be 11.6% among T2DM patients in Beijing. Having more diabetic complications and being divorced/widowed made the odds of having SubD 8-fold and 3-fold higher than not having it, respectively. The relationship between SubD and diabetes necessitates early screening for milder forms of depression, which can alleviate the social burden and individual impairment from major depression or other chronic diseases.
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Affiliation(s)
- Dandan Wang
- Department of Endocrinology, The 306th Teaching Hospital of People's Liberation Army, Peking University, Beijing, China
| | - Lintao Shi
- Department of Endocrinology, The 306th Hospital of People's Liberation Army, Beijing, China
| | - Leling Li
- School of Public Health, Peking University, Beijing, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Yufeng Li
- Department of Endocrinology and Metabolism, Pinggu Teaching Hospital, Capital Medical University, Beijing, China
| | - Yuan Xu
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Shinan Yin
- Department of Endocrinology, The 304th Hospital of People's Liberation Army, Beijing, China
| | - Qiaozhen Wu
- Outpatient Department of Sinopec Petroleum Exploration and Production Research Institute, Beijing, China
| | - Yu Yang
- Department of Endocrinology, Huairou Hospital, Beijing, China
| | - Xiaoming Zhuang
- Department of Endocrinology, Beijing Fu Xing Hospital, Capital Medical University, Beijing, China
| | - Yingli Gai
- Outpatient Department of Beihang University, Beijing, China
| | - Quanmin Li
- Department of Endocrinology, The Rocket Force Hospital of People's Liberation Army, Beijing, China
| | - Yanjun Liu
- Department of Endocrinology, The 306th Teaching Hospital of People's Liberation Army, Peking University, Beijing, China; Department of Endocrinology, The 306th Hospital of People's Liberation Army, Beijing, China.
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Darwish L, Beroncal E, Sison MV, Swardfager W. Depression in people with type 2 diabetes: current perspectives. Diabetes Metab Syndr Obes 2018; 11:333-343. [PMID: 30022843 PMCID: PMC6044353 DOI: 10.2147/dmso.s106797] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with depressive symptoms, and comorbid depression in those with T2DM has been associated with adverse clinical profiles. Recognizing and addressing psychological symptoms remain significant clinical challenges in T2DM. Possible mediators of the reciprocal relationship between T2DM and depression may include physical activity levels, effectiveness of self-management, distress associated with a new T2DM diagnosis, and frailty associated with advanced diabetes duration. The latter considerations contribute to a "J-shaped" trajectory from the time of diagnosis. There remain significant challenges to screening for clinical risks associated with psychological symptoms in T2DM; poorer outcomes may be associated with major depressive episodes, isolated (eg, anhedonic), or subsyndromal depressive symptoms, depressive-like symptoms more specific to T2DM (eg, diabetes-related distress), apathy or fatigue. In this review, we discuss current perspectives on depression in the context of T2DM with implications for screening and management of these highly comorbid conditions.
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Affiliation(s)
- Lina Darwish
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada,
| | - Erika Beroncal
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
| | - Ma Veronica Sison
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
| | - Walter Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada,
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Mocan AS, Iancu SS, Duma L, Mureseanu C, Baban AS. Depression in romanian patients with type 2 diabetes: prevalence and risk factors. ACTA ACUST UNITED AC 2016; 89:371-7. [PMID: 27547056 PMCID: PMC4990432 DOI: 10.15386/cjmed-641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 02/29/2016] [Indexed: 01/21/2023]
Abstract
Background and aims Co-existing major depression was found to have a negative impact on the diabetes outcome and the quality of life. The aim of the present study was to assess the prevalence of depressive symptoms in Romanian diabetes patients and to identify the risk factors associated with depression. Methods A total of 144 type 2 diabetes patients were included in the study. Five models of presumed predictors were used to assess the risk factors for depressive symptoms, using hierarchical regression analysis. Together with demographics, disease, lifestyle predictors, previous depressive symptoms and diabetes distress were taken into account. Results In our sample the prevalence of depression was 12.6%. Main risk factors for depressive symptoms were previous depressive symptoms which were associated with depression in both Model 4 (β=0.297, p=0.013) and Model 5 (β=0.239, p=0.017) and diabetes distress in Model 5 (β=0.540, p≤0.001). Employment (β =−0.276, p=0.029) and increased number of diabetes complications (β=0.236, p=0.017) became significant when diabetes distress was added to the analysis. Conclusions The overall prevalence of depressive symptoms was found to be in range with the prevalence identified in the literature. Previous depression and diabetes distress were both independently associated with depression, confirming the bidirectional relationship between depression and diabetes distress. Due to the consequences for daily living, screening for diabetes distress and depression should be done in primary care units both by physicians and trained nurses.
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Affiliation(s)
- Andreia S Mocan
- Center for Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital Cluj, Romania; Department of Psychology and Educational Sciences, Babes-Bolyai University, Cluj, Romania
| | - Silvia S Iancu
- Center for Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital Cluj, Romania
| | - Livia Duma
- Center for Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital Cluj, Romania
| | - Camelia Mureseanu
- Department of Psychology and Educational Sciences, Babes-Bolyai University, Cluj, Romania
| | - Adriana S Baban
- Department of Psychology and Educational Sciences, Babes-Bolyai University, Cluj, Romania
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Depression and diabetes: Debunking the myth of mind-body dichotomy. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2016. [DOI: 10.1016/j.injms.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yücel ŞÇ, Güler EK, Ak İ. Investigation of sleep quality, quality of life, anxiety and depression in patients with diabetes mellitus. Int J Diabetes Dev Ctries 2014. [DOI: 10.1007/s13410-014-0206-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Factorial and diagnostic validity of the Beck Depression Inventory-II (BDI-II) in Croatian primary health care. J Clin Psychol Med Settings 2014; 20:311-22. [PMID: 23549666 DOI: 10.1007/s10880-013-9363-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to examine the factorial and diagnostic validity of the Beck Depression Inventory-Second Edition (BDI-II) in Croatian primary health care. Data were collected using a medical outpatient sample (N = 314). Reliability measured by internal consistency proved to be high. While the Velicer MAP Test showed that extraction of only one factor is satisfactory, confirmatory factor analysis indicated the best fit for a 3-factor structure model consisting of cognitive, affective and somatic dimensions. Receiver operating characteristics (ROC) analysis demonstrated the BDI-II to have a satisfactory diagnostic validity in differentiating between healthy and depressed individuals in this setting. The area under the curve (AUC), sensitivity and specificity were high with an optimal cut-off score of 15/16. The implications of these findings are discussed regarding the use of the BDI-II as a screening instrument in primary health care settings.
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Sweileh WM, Abu-Hadeed HM, Al-Jabi SW, Zyoud SH. Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine. BMC Public Health 2014; 14:163. [PMID: 24524353 PMCID: PMC3929146 DOI: 10.1186/1471-2458-14-163] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 02/11/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a common chronic metabolic disorder and one of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control. METHODS This was a cross-sectional study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed for the presence of depressive symptoms using Beck Depression Inventory (BDI-II) scale. Patients' records were reviewed to obtain data pertaining to age, sex, marital status, Body Mass Index (BMI), level of education, smoking status, duration of diabetes mellitus, glycemic control using HbA1C test, use of insulin, and presence of additional illnesses. Patients' medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). RESULTS One hundred and sixty four patients (55.8%) of the total sample were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Statistical significant association was found between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30 kg/m2). No significant association between BDI score and glycemic control, duration of diabetes, and other socio-demographic factors was found. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II scores. CONCLUSION Prevalence of depression found in our study was higher than that reported in other countries. Although 40% of the screened patients were potential cases of depression, none were being treated with anti-depressants. Psychosocial assessment should be part of routine clinical evaluation of these patients at primary healthcare clinics to improve quality of life and decrease adverse outcomes among diabetic patients.
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Affiliation(s)
- Waleed M Sweileh
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | - Samah W Al-Jabi
- Department of Clinical and Comunity Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa’ed H Zyoud
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Guruprasad KG, Niranjan MR, Ashwin S. A study of association of depressive symptoms among the type 2 diabetic outpatients presenting to a tertiary care hospital. Indian J Psychol Med 2012; 34:30-3. [PMID: 22661804 PMCID: PMC3361839 DOI: 10.4103/0253-7176.96153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The prevalence of diabetes mellitus is increasing among Indian population over time. There are varying reports about the association of depression among type 2 diabetic individuals. However, there is limited data about this in India. AIMS To study the association of depression, demographic and socio-medical factors in type 2 diabetes patients. SETTINGS AND DESIGN Cross-sectional, epidemiological study. MATERIALS AND METHODS All the consenting type 2 diabetes mellitus patients attending to Medical OPD (n=210) were screened for symptoms of depression using beck depression inventory. All the participants were physically examined and a detailed psychiatric assessment were done. The relevant investigations were advised to identify comorbid conditions. STATISTICAL ANALYSIS Chi-square test with odd's ratio. RESULTS One-fourth of the screened diabetic patients were found to be having depression. Females and overweight individuals were found to have features of depression. Patients with long duration of diabetes and on combination of antidiabetic drugs were significantly associated with depression. Among depressed diabetics 25.9% were having Ischemic heart disease as a comorbid medical illness. CONCLUSIONS This study shows there is increased rate of depression among type 2 diabetic individuals. The interesting association of depression with several demographic and sociomedical factors have an important implication in type 2 diabetics.
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Affiliation(s)
- K G Guruprasad
- Department of Psychiatry, Hassan Institute of Medical Sciences, Hassan, Karnataka, India
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Ajduković D, Pibernik-Okanović M, Šekerija M, Hermanns N. The reach of depression screening preceding treatment: are there patterns of patients' self-selection? Int J Endocrinol 2012; 2012:148145. [PMID: 23209461 PMCID: PMC3502847 DOI: 10.1155/2012/148145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 09/21/2012] [Accepted: 10/09/2012] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the reach of depression screening followed by treatment programs for subsyndromal depression and explored demographic and clinical characteristics of patients who were reached versus those who were not. A two-item Patient Health Questionnaire-Depression was sent to 4196 type 2 diabetic patients. Positively screened patients were interviewed to assess the severity of depression, and those with subclinical symptoms were invited to treatment groups. The reach of screening procedure was evaluated by the total response rate, proportion of positive depression screenings, and proportion of eligible patients entering treatment programs. Predictors of responsiveness to screening and of participation in treatment were determined using logistic regression. Of the 34% of patients who returned the questionnaire (n = 1442), 40% reported depressive symptoms and a need for professional help (n = 581). Age (OR = 1.06, 95% CI = 1.05-1.08), BMI (OR = 1.02, 95% CI = 1.00-1.04), HbA1C (OR = .92, 95% CI = .86-.99), and LDL-cholesterol (OR = .90, 95% CI = .81-1.00) correlated with response to screening. Willingness to accept treatment was predicted by professional status (OR = 3.24, 95% CI = 1.53-6.87), education (OR = 1.21, 95% CI = 1.05-1.38), and BMI (OR = .91, 95% CI = .85-.98). Older patients with better diabetes control were more likely to be reached by postal screening for depressive symptoms. Professionally inactive, better-educated persons and those with lower BMI were more likely to participate in the intervention for subsyndromal depression.
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Affiliation(s)
- Dea Ajduković
- Unit for Psychological Medicine, Vuk Vrhovac University Clinic, Merkur Teaching Hospital, Zajčeva 19, 10000 Zagreb, Croatia
| | - Mirjana Pibernik-Okanović
- Unit for Psychological Medicine, Vuk Vrhovac University Clinic, Merkur Teaching Hospital, Zajčeva 19, 10000 Zagreb, Croatia
- *Mirjana Pibernik-Okanović:
| | - Mario Šekerija
- Service for the Epidemiology of Non-Communicable Diseases, Croatian National Institute of Public Health, Rockefellerova 7, 10000 Zagreb, Croatia
| | - Norbert Hermanns
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Diabetes Zentrum Mergentheim, Johann-Hammer-Straße 24, 97980 Bad Mergentheim, Germany
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Baumeister H, Hutter N, Bengel J, Härter M. Quality of life in medically ill persons with comorbid mental disorders: a systematic review and meta-analysis. PSYCHOTHERAPY AND PSYCHOSOMATICS 2011; 80:275-86. [PMID: 21646822 DOI: 10.1159/000323404] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 12/02/2010] [Indexed: 01/20/2023]
Abstract
BACKGROUND This systematic review aims to investigate the association between comorbid mental disorders and quality of life (QoL) in patients with chronic medical diseases. METHODS Studies investigating adults with diabetes mellitus, coronary artery disease, asthma, chronic back pain and colorectal cancer were included. Two reviewers independently extracted data and assessed methodological criteria. Effect sizes for QoL scores were analyzed in random-effects meta-analyses. Subgroup and sensitivity analyses were conducted. RESULTS The database search identified 7,291 references and 65 primary studies were included. Medically ill persons with comorbid mental disorders showed a significantly decreased overall (d = -1.10; 95% CI = -1.34 to -0.86), physical (d = -0.64; 95% CI = -0.74 to -0.53) and psychosocial (d = -1.18; 95% CI = -1.42 to -0.95) QoL compared to persons without mental disorders. Subgroup analyses did not reveal significant differences between the examined medical diseases or mental disorders. CONCLUSION The review provides evidence of a substantially reduced psychosocial and physical QoL in medically ill patients with comorbid mental disorders. This patient-reported outcome highlights the importance of recognizing and treating comorbid mental disorders in the medically ill.
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Affiliation(s)
- Harald Baumeister
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany.
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Ali S, Stone M, Skinner TC, Robertson N, Davies M, Khunti K. The association between depression and health-related quality of life in people with type 2 diabetes: a systematic literature review. Diabetes Metab Res Rev 2010; 26:75-89. [PMID: 20186998 DOI: 10.1002/dmrr.1065] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The relationships between co-morbid depression in people with diabetes and adverse outcomes including poor HbA(1c) control, adherence to medication and mortality have been examined and confirmed. However, as the awareness of the decrement to health-related quality of life (HRQOL) in people with diabetes and its clinical consequences grows, investigators have become increasingly interested in measuring HRQOL in clinical trials. Given that the psychological factors such as depression may contribute to diminished HRQOL, the present review sought to summarize the association between these variables in people with type 2 diabetes. Articles for a systematic review were obtained via a search performed using MEDLINE, EMBASE and PsycINFO (1980-2007).Fourteen articles fulfilled the inclusion criteria. Studies indicated that self-reported depressive symptoms markedly impaired HRQOL on several domains. However, depression was not related to all sub-domains of HRQOL in all studies, suggesting that the effects of depression on certain aspects of HRQOL may vary between clinical and demographic subgroups. Although a number of shortcomings identified in the current literature should be taken into account for future research, the importance of this review lies in the possibility it raises that the improvements in HRQOL and clinical practice may potentially be achieved by placing greater attention on the identification and management of depression.
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Affiliation(s)
- Saima Ali
- Health Sciences Research Institute, University of Warwick, Coventry, UK.
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Pouwer F, Geelhoed-Duijvestijn PHLM, Tack CJ, Bazelmans E, Beekman AJ, Heine RJ, Snoek FJ. Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands. Diabet Med 2010; 27:217-24. [PMID: 20546267 DOI: 10.1111/j.1464-5491.2009.02903.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Depression is common in diabetes, but the scope of the problem and associated correlates are not well established in specialist diabetes care. We aimed to determine the prevalence of depression among adult outpatients with Type 1 (T1DM) or Type 2 diabetes (T2DM) using both self-report measures and a diagnostic interview, and to establish demographic and clinical characteristics associated with depressive affect. METHODS A random sample of 2055 diabetes out-patients from three diabetes clinics was invited to participate. Depressive affect was assessed using the World Health Organization-5 Well Being Index (WHO-5), the Centre for Epidemiologic Studies-Depression scale (CESD) using predefined cut-off scores, and depressive disorder with the Composite International Diagnostic Interview (CIDI). Associations between depression and patient characteristics were explored using regression analyses. RESULTS Seven hundred and seventy-two patients completed the depression questionnaires. About one-third of T1DM patients and 37-43% of T2DM patients reported depressive affect (WHO-5). The prevalence of depressive affect (CESD) was 25% and 30% for men and women with T1DM, and 35% and 38% for men and women with T2DM, respectively. Based on the CIDI, 8% of T1DM patients (no gender difference) and 2% of men and 21% of women with T2DM suffered from a depressive disorder. Depressive affect was associated with poor glycaemic control and proliferative retinopathy in T1DM, while non-Dutch descent, obesity and neuropathy were correlates in T2DM. CONCLUSIONS Depressive symptoms and major depressive disorder constitute a common comorbid problem among Dutch out-patients with T1DM or T2DM and appear particularly common in migrants and women with T2DM.
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Affiliation(s)
- F Pouwer
- Diabetes Psychology Research Group, Department of Medical Psychology, EMGO-Institute, VU University Medical Centre, Amsterdam, the Netherlands.
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Yang J, Li S, Zheng Y. Predictors of depression in Chinese community-dwelling people with type 2 diabetes. J Clin Nurs 2009; 18:1295-304. [PMID: 19413557 DOI: 10.1111/j.1365-2702.2008.02703.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To examine levels of perceived social support and depression and to identify the related factors and predictors of depression among Chinese community-dwelling people with type 2 diabetes. BACKGROUND People with type 2 diabetes have a high risk for depression. Depression is a serious issue that leads to poor metabolic control and increased health care costs. However, little is known about the factors contributing to depression in Chinese people with type 2 diabetes. DESIGN A cross-sectional, descriptive correlation design was used. METHODS A convenient sample consisting of 148 people with type 2 diabetes participated. Personal information questionnaire was used to obtain socio-demographic characteristics; Zung Self-Rating Depression Scale and Multidimensional Scale of Perceived Social Support were used to measure depression and perceived social support, respectively. Spearman's correlation and Stepwise multiple regression analysis were used in data analysis. RESULTS The mean index score for depression was 46.53 and 39.2% of the subjects reported depression. The mean score for perceived social support was 5.24. Age, education level, marital status, monthly family income, living status, work status, regular exercise, duration of diabetes, diabetic complications, other chronic diseases and perceived social support were significantly correlated with depression. The best predictors of depression were perceived social support, duration of diabetes, regular exercise, work status and other chronic diseases. CONCLUSIONS Depression was common in people with type 2 diabetes. The people who had lower levels of perceived social support, longer diabetic duration, did not exercise regularly, were unemployed or retired and had other chronic diseases were more likely to report depression. RELEVANCE TO CLINICAL PRACTICE Nurses working in communities should assist people with type 2 diabetes in earlier detecting and treating their depression. Nurses should also design practical interventions to decrease depressive symptoms of those people through improving their diabetic conditions and perceived social support.
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Affiliation(s)
- Juan Yang
- Nursing Faculty, Hunan Traditional Chinese Medical College, Zhuzhou, China.
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Sotiropoulos A, Papazafiropoulou A, Apostolou O, Kokolaki A, Gikas A, Pappas S. Prevalence of depressive symptoms among non insulin treated Greek type 2 diabetic subjects. BMC Res Notes 2008; 1:101. [PMID: 18957113 PMCID: PMC2590605 DOI: 10.1186/1756-0500-1-101] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2008] [Accepted: 10/28/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is common among diabetic subjects. We conducted the present study to estimate the prevalence of depression in subjects with type 2 diabetes (T2D) in Greece. METHODS The study sample consisted of 320 T2D subjects without overt macrovascular disease attending the diabetes outpatient clinic of our hospital, from June 2007 to December 2007. Depressive symptoms were measured using the 21-item Beck Depression Inventory, modified for use in diabetic subjects. RESULTS Of the study subjects 107 (33.4%) reported elevated depressive symptoms. More women than men with diabetes reported symptoms of depression (48.4% vs. 12.7%, P < 0.001). In the female study group, depressive symptoms were correlated with HbA1c (P = 0.04), and duration of diabetes (P = 0.004). In the male study group, univariate linear regression analysis showed no significant relationships between depressive symptoms and the testing variables. CONCLUSION The prevalence of depression in Greek T2D subjects is high. Diabetic female subjects showed increased levels of depressive symptoms compared with male subjects. Independent risk factors of depressive symptoms in diabetic female subjects were diabetes duration and glycemic control.
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Affiliation(s)
- Alexios Sotiropoulos
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Saint Panteleimon" – Piraeus, Greece
| | - Athanasia Papazafiropoulou
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Saint Panteleimon" – Piraeus, Greece
| | - Ourania Apostolou
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Saint Panteleimon" – Piraeus, Greece
| | - Anthi Kokolaki
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Saint Panteleimon" – Piraeus, Greece
| | - Aristofanis Gikas
- Department of General Practice, Health Centre of Kalivia, Kalivia-Lagonisi, Athens, Greece
| | - Stavros Pappas
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Saint Panteleimon" – Piraeus, Greece
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Pibernik-Okanovic M, Begic D, Peros K, Szabo S, Metelko Z. Psychosocial factors contributing to persistent depressive symptoms in type 2 diabetic patients: a Croatian survey from the European Depression in Diabetes Research Consortium. J Diabetes Complications 2008; 22:246-53. [PMID: 18413168 DOI: 10.1016/j.jdiacomp.2007.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Revised: 01/29/2007] [Accepted: 03/01/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The study was aimed at exploring a 1-year course of depression in persons with type 2 diabetes and analysing demographic, disease-related, and psychological variables that may predict persistent depressive symptoms. PATIENTS AND METHODS One hundred patients from a randomly selected sample of 470 outpatients were found to be suffering from severe depressive symptoms. They were followed and re-examined for depression after 1 year. Baseline depression was assessed by the Center for Epidemiologic Studies--Depression scale (CES-D) and a face-to-face diagnostic interview relying on the DSM-IV. Nonparametric tests for between-group differences were used to compare patients who recovered from depression with those who still suffered from severe depressive symptoms. Multiple logistic regression was used to determine predictors of depression persistence. RESULTS Seventy-nine of 100 patients with baseline depression scores indicative of severe depression were reached at 1-year follow-up. Among them, 53% were shown to have improved depressive symptoms to CES-D <16, while 47% continued to suffer from severe depressive disturbances (CES-D >or=16). Logistic regression analysis indicated that psychosocial variables predicted persistently elevated depressive symptoms better than demographic and diabetes-related ones. Clinical depression at baseline (OR=3.8, CI 1.31-10.98, P=.01), diabetes-related distress (OR=3.3, CI 1.01-10.98, P=.05), and social and physical quality-of-life aspects (OR=0.92, CI 0.88-0.97, P=.0005 and OR=0.94, CI 0.90-0.98, P=.002, respectively) were shown to be independent predictors of 1-year depression outcomes. CONCLUSIONS Severity of baseline depression, a degree to which depression disrupted the patients' quality of life, and concomitant emotional problems related to diabetes were shown to be associated with persistently elevated depressive symptoms.
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Abstract
OBJECTIVE The aim of this study was to compare psychiatric morbidity among diabetic patients, asthmatics and healthy individuals and also to assess the association of psychiatric morbidity and other variables with quality of life among diabetes patients. METHOD For each respondent, the questionnaire on sociodemographic and clinical variables was completed. They also completed the Zung Self-Rating Depression Scale and the State Trait Anxiety Inventory (STAI 1). Diabetic patients also completed the Diabetic Well-Being Questionnaire. RESULTS A total of 180 subjects were used for this study-80 diabetics (males=37, females=43) were compared with 50 asthmatics (males=22, females=28) and 50 healthy individuals (males=23, females=27). Depression was more prevalent among diabetic patients (20%) compared with asthmatics (12%) and healthy individuals (4%), while anxiety was more prevalent among asthmatics (34%) compared with diabetics (20%) and healthy individuals (8%). Predictors of depression include age of the patient, poor glycemic control and duration of diabetes mellitus. Factors that correlated significantly with diabetic general well-being include depression, anxiety and fasting blood glucose level. Depression and the presence of comorbid medical conditions significantly predicted a low quality of life. CONCLUSION Psychiatric morbidity has significant effects on diabetic patients' quality of life.
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Zahid N, Asghar S, Claussen B, Hussain A. Depression and diabetes in a rural community in Pakistan. Diabetes Res Clin Pract 2008; 79:124-7. [PMID: 17692423 DOI: 10.1016/j.diabres.2007.07.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Accepted: 07/05/2007] [Indexed: 11/25/2022]
Abstract
AIMS To determine the prevalence of depression amongst subjects with diabetes and associated risk factors in a rural area of Pakistan. METHODS One thousand two hundred and ninety rural individuals aged 20 years and above were randomly included in the study. Fasting plasma glucose (FPG), BMI, WHR were recorded. Depression was assessed by Montgomery-Asberg Depression Rating Scale (MADRS). RESULTS The prevalence of depression was 5.4% (95% CI: 4.2-6.6), slightly higher amongst women compared to men. Depression prevalence was 14.7% (6.6-22.8) amongst those with diabetes as opposed to 4.9 (3.7-6.1) amongst those without diabetes. Age, gender, and diabetes were independent risk factors for depression, while obesity had a protective effect. CONCLUSIONS A relatively low prevalence of depression were recorded amongst the rural inhabitants, while a high prevalence was observed amongst diabetic subjects in Pakistan. This may suggest that psychiatric intervention may be required both for improved care and for primary prevention of diabetes.
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Affiliation(s)
- Naeem Zahid
- Department of General Practice and Community Medicine, University of Oslo, Oslo, Norway.
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Asghar S, Hussain A, Ali SMK, Khan AKA, Magnusson A. Prevalence of depression and diabetes: a population-based study from rural Bangladesh. Diabet Med 2007; 24:872-7. [PMID: 17403122 DOI: 10.1111/j.1464-5491.2007.02136.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIMS To determine the extent of depressive symptoms in a rural community of Bangladesh and its association with newly recognized diabetes. METHODS Depressive symptoms were assessed in 184 newly diagnosed diabetic subjects and 768 randomly selected individuals without diabetes. The Montogomery and Aasberg Depression Rating Scale (MADRS) was used to assess depressive symptoms. A structured interview was performed to obtain socio-demographic and economic information and anthropometric measures were collected. Fasting plasma glucose was measured by the HemoCue glucose analyser. RESULTS Twenty-nine percent of male and 30.5% of female participants with diabetes and 6.0% of male and 14.6% of female subjects without diabetes had depressive symptoms rating > or = 20 on the MADRS. An association between depressive symptoms and diabetes was found (P < 0.01). After controlling for potential confounding factors including age, gender, fasting plasma glucose > 7.0 mmol/l and waist-hip ratio, the association of depression with diabetes remained significant. CONCLUSIONS An unexpectedly high level of unrecognized depressive symptoms was found in the general rural population of Bangladesh. These are among the first data to suggest that depressive symptoms in this culture are common, especially in women. Depression is particularly common in those with diabetes. Psychiatric intervention may be necessary in addition to lifestyle changes to prevent the exponential increase in the occurrence of Type 2 diabetes. In addition, a common approach including psychiatric treatment in diabetes care may be necessary to achieve improved glycaemic control in this population.
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Affiliation(s)
- S Asghar
- Institute for Psychiatric Research, University of Oslo, Oslo, Norway.
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Hu J, Amoako EP, Gruber KJ, Rossen EK. The relationships among health functioning indicators and depression in older adults with diabetes. Issues Ment Health Nurs 2007; 28:133-50. [PMID: 17365164 DOI: 10.1080/01612840601096305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A common health problem among the elderly with diabetes is the onset of depressive symptoms that can adversely affect self-care and control of diabetes. The study examined the relationships of gender, race, comorbid conditions, symptom distress, and functional status with depression in a sample (N = 55) of older adults with diabetes. Most participants were female and black; mean age was 73 years. Gender and symptom distress were the strongest predictors of depression, accounting for 53% of the variance in depression. Although the sample was reasonably high functioning with only moderate levels of symptom distress, these findings serve as an important reminder for nurses that even moderate levels of symptom distress may be an indicator of depressive symptomatology among older diabetic adults.
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Affiliation(s)
- Jie Hu
- The University of North Carolina at Greensboro, School of Nursing, Greensboro, North Carolina 27402-6170, USA.
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