The Influence of Diabetes-related Distress on Depression

Abstract

Depressive disorders in diabetic patients are nearly twice as likely compared to the non-diabetic population. There is evidence that patients’ perception of diabetes is a decisive aspect of this association. Therefore this study prospectively investigates the role of patients’ perceived diabetesrelated distress on incidence depression and recovery. 343 patients with type 1 diabetes completed the CES-D and the Problem Areas in Diabetes Scale (PAID) at baseline and at the 6-month follow-up. A CES-D score of ≥16 indicated elevated depressive symptoms. A PAID score of ≥30 indicated elevated diabetes-related distress. Logistic regression analyses were performed with recovery from and incidence of depressive symptoms as dependent variables. Independent variable was diabetesrelated distress adjusted for possible demographic (age, gender, BMI) and medical confounders (diabetes duration, HbA1c, insulin pump therapy, and late complications). At baseline 130 patients (37.9%) reported elevated depressive symptoms and 40 of these patients (30.8%) recovered 6 months later. Of the 213 patients without elevated depressive symptoms, 27 (12.7%) had elevated depressive symptoms 6 months later. Diabetes-related distress at baseline diminished the chance to recover from elevated depressive symptoms by 64% (OR = 0.36, p<.05). In addition, the chance for incident depressive symptoms if diabetes-related distress was present at baseline is 2.5 times more likely in contrast to no diabetes-related distress at baseline (OR=2.5; p<.05). In both analyses, no other variables reached a signifi cant infl uence. It could be demonstrated that preventing diabetes-related distress is a protective factor regarding the incidence of elevated depressive symptoms. Furthermore, preventing diabetes-related distress supports the recovery from already elevated depressive symptoms. This supports the notion that diabetes per se is not a risk factor for depressive disorders but the perceived emotional distress is