Levels and Risks of Depression and Anxiety Symptomatology Among Diabetic Adults

OBJECTIVE To determine levels of depression and anxiety symptoms among adults with diabetes and identify factors associated with increased risk. RESEARCH DESIGN AND METHODS This study administered self-report symptom inventories to patients at the beginning (n = 634) and end (n = 578) of an outpatient diabetes education program. Subjects (n = 246) contacted by mail 6 months later completed the same instruments. RESULTS Rates of disturbance for depression (41.3%; 95% CI: 37.4–45.2%) and anxiety (49.2%; 95% CI: 45.3–53.1%) were higher than those typical in the general population (10–20%). Probability of disturbance ranged from 5–7% for those with the lowest risk profile to 82–92% for those with the highest risk profile. Diabetes-related complications were the only disease factor associated with significantly increased risk of disturbance. Women and those with less education were at much higher risk. Only 13% of those followed for 6 months were disturbed at all three time-points. CONCLUSIONS Diabetes is associated with increased risk of psychological disturbance, especially for those with more diabetes-related complications. Sociodemographic factors account for much of the risk differential among people with diabetes.

[1]  R. Clouse,et al.  Prevalence of Depression in Adults With Diabetes: An epidemiological evaluation , 1993, Diabetes Care.

[2]  W. Manning,et al.  The Effects of Psychological Distress and Psychological Well-Being on Use of Medical Services , 1992, Medical care.

[3]  L. Rand,et al.  Psychologic stress and glycemic control: a comparison of patients with and without proliferative diabetic retinopathy. , 1985, Psychosomatic medicine.

[4]  D. Ford,et al.  Depression and Risk for Onset of Type II Diabetes: A prospective population-based study , 1996, Diabetes Care.

[5]  R. Friis,et al.  Diabetes, depression and employment status. , 1986, Social science & medicine.

[6]  G. Rodin,et al.  Influence of functional impairment and social support on depressive symptoms in persons with diabetes. , 1990, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[7]  D. Kirschenbaum,et al.  Obese people who seek treatment have different characteristics than those who do not seek treatment. , 1993, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[8]  E. Fisher,et al.  Depressive symptomatology and smoking among persons with diabetes. , 1994, Research in nursing & health.

[9]  M. Kovács,et al.  Biomedical and Psychiatric Risk Factors for Retinopathy Among Children With IDDM , 1995, Diabetes Care.

[10]  R. Turner,et al.  Physical disability and depression: a longitudinal analysis. , 1988, Journal of health and social behavior.

[11]  D. Sutherland,et al.  Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus. , 1988, Archives of general psychiatry.

[12]  R. K. Bernstein Depression in Adults With Diabetes , 1993, Diabetes Care.

[13]  W. K. Davis,et al.  Psychosocial adjustment to and control of diabetes mellitus: differences by disease type and treatment. , 1987, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[14]  R R Frerichs,et al.  Prevalence of depression in Los Angeles County. , 1981, American journal of epidemiology.

[15]  K. Wells,et al.  Course of depression in patients with hypertension, myocardial infarction, or insulin-dependent diabetes. , 1993, The American journal of psychiatry.

[16]  E. Fisher,et al.  Relationships among Social Support, Diabetes Outcomes, and Morale for Older Men and Women , 1992 .

[17]  D. Bennett,et al.  Depression among children with chronic medical problems: a meta-analysis. , 1994, Journal of pediatric psychology.

[18]  M Peyrot,et al.  Consumer satisfaction and perceived quality of outpatient health services. , 1993, Journal of health care marketing.

[19]  J. Flack Effect of Diabetes Education on Self-Care Metabolic Control and Emotional Well-Being , 1990, Diabetes Care.

[20]  Differential Effect of Diabetes Education on Self-Regulation and Life-Style Behaviors , 1991, Diabetes Care.

[21]  S. Murrell,et al.  Prevalence of depression and its correlates in older adults. , 1983, American journal of epidemiology.

[22]  G W Comstock,et al.  Symptoms of depression in two communities , 1977, Psychological Medicine.

[23]  A. C. Nielsen,et al.  Prevalence by Self-report questionnaire and recognition by nonpsychiatric physicians. , 1980, Archives of general psychiatry.

[24]  R. Bland Psychiatric Disorders in America: The Epidemiologic Catchment Area Study , 1992 .

[25]  W W Zung,et al.  A rating instrument for anxiety disorders. , 1971, Psychosomatics.

[26]  M. Gallant,et al.  Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes. , 1994, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[27]  L. Epstein,et al.  Depressive Symptomatology in Obese Adults With Type II Diabetes , 1990, Diabetes Care.

[28]  S. Weyerer,et al.  Psychiatric disorders and diabetes--results from a community study. , 1989, Journal of psychosomatic research.