Physical inactivity among adults with diabetes mellitus and depressive symptoms: results from two independent national health surveys (original) (raw)
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International Journal of Geriatric Psychiatry, 2010
Background: This longitudinal study of patients with diabetes examined the relationship between changes in depressive symptoms and changes in diabetes self-care behaviors over 5 years. Design, Patients and Measurements: A total of 2759 patients with diabetes enrolled in a large HMO were followed over a 5-year period. Patients filled out a baseline mail survey and participated in a telephone interview 5 years later. Depression was measured with the Patient Health Questionnaire (PHQ-9) and diabetes self-care was measured with the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. Baseline and longitudinal evidence of diabetes and medical disease severity and complications were measured using ICD-9 and CPT codes and verified by chart review. Results: At the 5-year follow-up, patients with diabetes with either persistent or worsening depressive symptoms compared to those in the no depression group had significantly fewer days per week of following a healthy diet or participating in !30 min of exercise. At 5-year follow-up, patients with clinical improvement in depression symptoms showed no differences compared to the no depression group on number of days per week of adherence to diet but showed deterioration in adherence to exercise on some, but not all, measures. Conclusions: Patients with diabetes with persistent or worsening depressive symptoms over 5 years had significantly worse adherence to dietary and exercise regimens than patients in the no depression group. These results emphasize the need to further develop and test interventions to improve both quality of care for depression and self-care in diabetes patients.
Journal of Young Pharmacists, 2015
Objective: The objective was to assess depression as comorbidity among patients of diabetes mellitus (DM) using Beck Depression Inventory II (BDI II) scale. Materials and Method: A cross sectional survey was conducted in Pakistan for 3 months targeting patients of diabetes mellitus DM and assessing their depression as a comorbidity using BDI II questionnaire. Data analysis was carried out using SPSS version 20. Descriptive statistics, cross tabulation and Chi square (X 2) tests were employed. Results: Majority of the target group was normal (N=58, 28%) while a quarter of the sample suffers from mild depression (N=54, 26.1%). Some suffered from moderate depression (N=43, 20.8%) followed by a tenth of segment who suffered from severe depression (N=20, 9.7%). Few were reported to suffer from extreme episodes of depression (N=4, 1.9%). The depression was also statistically associated with patients' BMI (<0.05), disease duration (<0.01), family history (<0.01) and glycated haemoglobin Hb A1c (<0.01). Conclusion: Likelihood of suffering from depression in DM is high. Modifiable factors i.e. BMI, HBA1c, etc. and non modifiable factors of DM such as genetic predisposition and disease duration play an important role in occurrence of depression as comorbidity. Educating the patients about DM can prove effective in dealing with the disease and its complications since patients will be prepared and be taught aggressive self management which may also prove helpful in managing comorbid depression.
Behavioral and Clinical Factors Associated With Depression Among Individuals With Diabetes
Diabetes Care, 2004
The goal of this study was to determine the behavioral and clinical characteristics of diabetes that are associated with depression after controlling for potentially confounding variables. A population-based mail survey was sent to patients with diabetes from nine primary care clinics of a health maintenance organization. The Patient Health Questionnaire was used to diagnose depression, and automated diagnostic, pharmacy, and laboratory data were used to measure diabetes treatment intensity, HbA(1c) levels, and diabetes complications. Independent factors that were associated with a significantly higher likelihood of meeting criteria for major depression included younger age, female sex, less education, being unmarried, BMI &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30 kg/m(2), smoking, higher nondiabetic medical comorbidity, higher numbers of diabetes complications in men, treatment with insulin, and higher HbA(1c) levels in patients &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;65 years of age. Independent factors associated with a significantly higher likelihood of meeting criteria for minor depression included younger age, less education, non-Caucasian status, BMI &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 30 kg/m(2), smoking, longer duration of diabetes, and a higher number of complications in older (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 65 years) patients. Smoking and obesity were associated with a higher likelihood of meeting criteria for major and minor depression. Diabetes complications and elevated HbA(1c) were associated with major depression among demographic subgroups: complications among men and HbA(1c) among individuals &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;65 years of age. Older patients with a higher number of complications had an increased likelihood of minor depression.
Epidemiologic Studies Depression (CES-D) Scale and the Problem Areas in Diabetes (PAID)
2015
Aims-To examine the relationship between depressive symptomatology, diabetes-related distress and aspects of diabetes self-care in a cohort of individuals with Type 1 diabetes. Methods-Individuals with Type 1 diabetes taking part in the Pittsburgh Epidemiology of Diabetes Complications Study completed the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression (CES-D) Scale and the Problem Areas in Diabetes (PAID) scale. Self-care was measured by physical activity in the past week and over the previous year, frequency of blood glucose/urine testing, smoking status and alcohol intake. Results-Clinically significant levels of depressive symptomatology (i.e. scores ≥ 16) were reported by 14% of the study population on the BDI and by 18% on the CES-D. There were strong correlations between depressive symptoms and diabetes-related distress (PAID scores) and physical activity. Multivariate analyses indicated that depression was independently associated with diabetes-related distress scores and with physical activity, but not with frequency of blood glucose testing. Conclusions-These findings have implications for clinical practice and treatment of both psychological morbidity and diabetes. There may be significant effects of depression on aspects of diabetes self-care. Further prospective studies are required to confirm these findings.
Diabetic medicine : a journal of the British Diabetic Association, 2015
To quantify the impact of depressive symptoms on completion of exercise-based rehabilitation for Type 2 diabetes management. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale in a prospective cohort of consecutive patients with Type 2 diabetes entering a 6-month hybrid (home- and clinic-based) exercise rehabilitation programme. Attendance at exercise sessions was monitored and programme completion/non-completion was ascertained. Of the programme participants (n=624, mean age 55.6±10.5 years, 47% male), 26.8% endorsed significant depressive symptoms (depression score ≥16) and 68.1% completed the intervention, attending 54.6±30.0% of supervised exercise sessions. Baseline depressive symptoms (depression scale score ≥16) increased the risk of non-completion [hazard ratio 1.49 (95% CI 1.10-2.03); P = 0.010], and predicted fewer sessions attended (β=-2.1, P= 0.002) in adjusted models. A depression score threshold of ≥10 (48.4% of participants...
Prevalence of Depression and its Impact in Diabetes Management – A Pilot Study
International Journal of Nursing Research
Introduction: Global prevalence of diabetes and depression is increasing remarkably. Depression is 2–3 times more in diabetic population than non-diabetic people. Appropriate management mainly – diet, physical activity, medication, and regular screening and treatment can control, prevent, and delay diabetic complications. Aim: This study aims to assess the prevalence and impact of depression in diabetes self-management. Materials and Methods: This cross-sectional descriptive survey included 50 diabetic patients in the endocrinology outpatient department at selected medical college and hospital, Kolkata, from February 2021 to March2021. Depression and diabetic self-management were assessed through Patient Health Questionnaire-9 (PHQ-9) and Diabetes Self-Management Questionnaire (DSMQ), respectively. Based on the WHO’s five dimension of adherence, patients’ background information were collected. Results: PHQ-9 score indicates that 62% of the diabetics patients were having varied degre...
Iranian Journal of Psychiatry and Behavioral Sciences, 2018
Background: Co-morbid depression in patients with chronic disease is associated with weak self-care and high complications. Objective: The study aimed to determine the relationship of self-care behaviors and the kind of chronic disease with depression in adults with chronic disease in Isfahan, Iran. Methods: This cross-sectional study was conducted in government healthcare centers. A total of 483 eligible consent respondents participated from March 2015 to June 2015. The "Stanford self-management questionnaire" and the patient health questionnaire (PHQ-9) were used for the assessment of self-management behaviors and depression. Data were analyzed using the SPSS 17 software. Results: The prevalence of depression in participants was 14.7%. There was a significant relationship between self-management behaviors such as physical activity (P < 0.05) and medication adherence (P < 0.001), and depression. The risk of depression was greater in rheumatoid arthritis disease patients (OR = 4.41, 95% CI (0.47-5.38), P > 0.001) and skeletal disease patients (OR = 1.70, 95% CI (1.03-2.77), P < 0.05) than in other chronic disease patients. Conclusions: We found a negative association between depression and self-care activities in Iranian patients with chronic diseases. Psychological treatment for depression should be considered to improve the prognosis of chronic diseases.