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Depression and diabetes symptom burden.
Gen Hosp Psychiatry. 2004 Nov-Dec; 26(6):430-6.GH

Abstract

OBJECTIVE

To examine the relationship among patient-reported diabetes symptoms, severity of depressive illness and objective measures of diabetes control and severity among a population-based sample of patients with diabetes.

METHODS

A mailed survey was sent to all patients with diabetes from nine primary care clinics of a Health Maintenance Organization. The Patient Health Questionnaire (PHQ-9) was used to diagnose major depression, the Self-Completion Patient Outcome instrument assessed diabetes symptoms and automated medical record data were used to measure diabetes treatment intensity, HbA(1c) levels, diabetes complications and medical comorbidity. Analysis of covariance (ANCOVA) was used to determine if the number of diabetes symptoms was related to having major depression and to number of depressive symptoms. Logistic regression analyses determined the relative strengths of the associations between each individual diabetic symptom and presence of major depression, HbA(1c) levels above 8.0% and two or more diabetes complications.

RESULTS

Among 4168 patients with diabetes, those with major depression (N=487) reported significantly more diabetes symptoms (mean=4.40) than participants without depression (mean=2.46) after adjusting for demographic characteristics, objective measures of diabetes severity and medical comorbidity [F(1,4029)=339.31, P<.0001]. The overall number of diabetes symptoms was related to the number of depressive symptoms (from 0 to 9) endorsed by participants [F(9,4021)=110.05, P<.0001]. Logistic regression analyses found that depression was significantly related to each of the 10 diabetes symptoms (all P<.001).

CONCLUSIONS

The depression-diabetes symptom association is stronger than the association of diabetes symptoms with measures of glycemic control and diabetes complications.

Authors+Show Affiliations

Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. ludman.e@ghc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15567208

Citation

Ludman, Evette J., et al. "Depression and Diabetes Symptom Burden." General Hospital Psychiatry, vol. 26, no. 6, 2004, pp. 430-6.
Ludman EJ, Katon W, Russo J, et al. Depression and diabetes symptom burden. Gen Hosp Psychiatry. 2004;26(6):430-6.
Ludman, E. J., Katon, W., Russo, J., Von Korff, M., Simon, G., Ciechanowski, P., Lin, E., Bush, T., Walker, E., & Young, B. (2004). Depression and diabetes symptom burden. General Hospital Psychiatry, 26(6), 430-6.
Ludman EJ, et al. Depression and Diabetes Symptom Burden. Gen Hosp Psychiatry. 2004 Nov-Dec;26(6):430-6. PubMed PMID: 15567208.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression and diabetes symptom burden. AU - Ludman,Evette J, AU - Katon,Wayne, AU - Russo,Joan, AU - Von Korff,Michael, AU - Simon,Gregory, AU - Ciechanowski,Paul, AU - Lin,Elizabeth, AU - Bush,Terry, AU - Walker,Edward, AU - Young,Bessie, PY - 2004/05/24/received PY - 2004/08/26/accepted PY - 2004/11/30/pubmed PY - 2005/2/24/medline PY - 2004/11/30/entrez SP - 430 EP - 6 JF - General hospital psychiatry JO - Gen Hosp Psychiatry VL - 26 IS - 6 N2 - OBJECTIVE: To examine the relationship among patient-reported diabetes symptoms, severity of depressive illness and objective measures of diabetes control and severity among a population-based sample of patients with diabetes. METHODS: A mailed survey was sent to all patients with diabetes from nine primary care clinics of a Health Maintenance Organization. The Patient Health Questionnaire (PHQ-9) was used to diagnose major depression, the Self-Completion Patient Outcome instrument assessed diabetes symptoms and automated medical record data were used to measure diabetes treatment intensity, HbA(1c) levels, diabetes complications and medical comorbidity. Analysis of covariance (ANCOVA) was used to determine if the number of diabetes symptoms was related to having major depression and to number of depressive symptoms. Logistic regression analyses determined the relative strengths of the associations between each individual diabetic symptom and presence of major depression, HbA(1c) levels above 8.0% and two or more diabetes complications. RESULTS: Among 4168 patients with diabetes, those with major depression (N=487) reported significantly more diabetes symptoms (mean=4.40) than participants without depression (mean=2.46) after adjusting for demographic characteristics, objective measures of diabetes severity and medical comorbidity [F(1,4029)=339.31, P<.0001]. The overall number of diabetes symptoms was related to the number of depressive symptoms (from 0 to 9) endorsed by participants [F(9,4021)=110.05, P<.0001]. Logistic regression analyses found that depression was significantly related to each of the 10 diabetes symptoms (all P<.001). CONCLUSIONS: The depression-diabetes symptom association is stronger than the association of diabetes symptoms with measures of glycemic control and diabetes complications. SN - 0163-8343 UR - https://www.unboundmedicine.com/medline/citation/15567208/Depression_and_diabetes_symptom_burden_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-8343(04)00109-4 DB - PRIME DP - Unbound Medicine ER -