Anxiety and depression in diabetes care: longitudinal associations with health-related quality of life

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Abstract

Anxiety and depression are commonly found in patients with diabetes, but little is known about how the anxiety and depression symptoms of diabetes patients and the health-related quality of life (HRQoL) over time influence each other. Therefore, we conducted a survey among patients with diabetes (T1) and repeated the survey after 3 months (T2). Linear regression models and cross-lagged structural equation models were used to analyze the associations between anxiety and depression symptoms and HRQoL within and across time intervals. Correcting for baseline index and potential confounders, the HRQoL index at T2 reflected the change in anxiety/depression between T1 and T2 more than anxiety/depression at T1 ( P < 0.05). Similarly, anxiety and depression at T2 reflected the change in the EQ-5D index over time more than the index at baseline ( P < 0.05). Our longitudinal data fitted well in a cross-lagged model with bi-directional pathways of associations between anxiety and HRQoL, as well as depression and HRQoL, among adult patients with diabetes (x ²/df = 1.102, P = 0.256; CFI = 1.000, RMSEA = 0.030). Our findings support early detection of anxiety and depression, as well as comprehensive efforts improving HRQoL for patients with diabetes.

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Bidirectional Association Between Depression and Metabolic Syndrome

An Lian Pan, NaNa Keum, Olivia Okereke … (2012)

OBJECTIVE Epidemiological studies have repeatedly investigated the association between depression and metabolic syndrome (MetS). However, the results have been inconsistent. This meta-analysis aimed to summarize the current evidence from cross-sectional and prospective cohort studies that evaluated this association. RESEARCH DESIGN AND METHODS MEDLINE, EMBASE, and PsycINFO databases were searched for articles published up to January 2012. Cross-sectional and cohort studies that reported an association between the two conditions in adults were included. Data on prevalence, incidence, unadjusted or adjusted odds ratio (OR), and 95% CI were extracted or provided by the authors. The pooled OR was calculated separately for cross-sectional and cohort studies using random-effects models. The I 2 statistic was used to assess heterogeneity. RESULTS The search yielded 29 cross-sectional studies (n = 155,333): 27 studies reported unadjusted OR with a pooled estimate of 1.42 (95% CI 1.28–1.57; I 2 = 55.1%); 11 studies reported adjusted OR with depression as the outcome (1.27 [1.07–1.57]; I 2 = 60.9%), and 12 studies reported adjusted OR with MetS as the outcome (1.34 [1.18–1.51]; I 2 = 0%). Eleven cohort studies were found (2 studies reported both directions): 9 studies (n = 26,936 with 2,316 new-onset depression case subjects) reported adjusted OR with depression as the outcome (1.49 [1.19–1.87]; I 2 = 56.8%), 4 studies (n = 3,834 with 350 MetS case subjects) reported adjusted OR with MetS as the outcome (1.52 [1.20–1.91]; I 2 = 0%). CONCLUSIONS Our results indicate a bidirectional association between depression and MetS. These results support early detection and management of depression among patients with MetS and vice versa.

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Diabetes, depression, and quality of life: a population study.

R D Goldney, P. J. Phillips, L Fisher … (2004)

The aim of the study was to assess the prevalence of diabetes and depression and their associations with quality of life using a representative population sample. The study consisted of a representative population sample of individuals aged > or = 15 years living in South Australia comprising 3,010 personal interviews conducted by trained health interviewers. The prevalence of depression in those suffering doctor-diagnosed diabetes and comparative effects of diabetic status and depression on quality-of-life dimensions were measured. The prevalence of depression in the diabetic population was 24% compared with 17% in the nondiabetic population. Those with diabetes and depression experienced an impact with a large effect size on every dimension of the Short Form Health-Related Quality-of-Life Questionnaire (SF-36) as compared with those who suffered diabetes and who were not depressed. A supplementary analysis comparing both depressed diabetic and depressed nondiabetic groups showed there were statistically significant differences in the quality-of-life effects between the two depressed populations in the physical and mental component summaries of the SF-36. Depression for those with diabetes is an important comorbidity that requires careful management because of its severe impact on quality of life.

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The utility of 'country of birth' for the classification of ethnic groups in health research: the Dutch experience.

Karien Stronks, Isik Kulu-Glasgow, Charles Agyemang (2009)

The relationship between ethnicity and health is attracting increasing attention in international health research. Different measures are used to operationalise the concept of ethnicity. Presently, self-definition of ethnicity seems to gain favour. In contrast, in the Netherlands, the use of country of birth criteria have been widely accepted as a basis for the identification of ethnic groups. In this paper, we will discuss its advantages as well as its limitations and the solutions to these limitations from the Dutch perspective with a special focus on survey studies. The country of birth indicator has the advantage of being objective and stable, allowing for comparisons over time and between studies. Inclusion of parental country of birth provides an additional advantage for identifying the second-generation ethnic groups. The main criticisms of this indicator seem to refer to its validity. The basis for this criticism is, firstly, the argument that people who are born in the same country might have a different ethnic background. In the Dutch context, this limitation can be addressed by the employment of additional indicators such as geographical origin, language, and self-identified ethnic group. Secondly, the country of birth classification has been criticised for not covering all dimensions of ethnicity, such as culture and ethnic identity. We demonstrate in this paper how this criticism can be addressed by the use of additional indicators. In conclusion, in the Dutch context, country of birth can be considered a useful indicator for ethnicity if complemented with additional indicators to, first, compensate for the drawbacks in certain conditions, and second, shed light on the mechanisms underlying the association between ethnicity and health.

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Author and article information

Contributors

Xiaona Liu:

ORCID: http://orcid.org/0000-0002-0183-8011

x.liu@erasmusmc.nl

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 20 May 2020

Publication date PMC-release: 20 May 2020

Publication date Collection: 2020

Volume: 10

Electronic Location Identifier: 8307

Affiliations

[1 ]ISNI 000000040459992X, GRID grid.5645.2, Department of Public Health, , Erasmus MC, University Medical Center Rotterdam, ; Rotterdam, the Netherlands

[2 ]ISNI 000000040459992X, GRID grid.5645.2, Department of Internal Medicine, , Erasmus MC, University Medical Center Rotterdam, ; Rotterdam, the Netherlands

[3 ]ISNI 000000040459992X, GRID grid.5645.2, Department of Medical Psychology and Psychotherapy, , Erasmus MC, University Medical Center Rotterdam, ; Rotterdam, the Netherlands

[4 ]Department of Infectious Disease Control, Shenzhen Bao’an Center for Disease Control and Prevention, Shenzhen, China

Author information

Xiaona Liu http://orcid.org/0000-0002-0183-8011

Eric Sijbrands http://orcid.org/0000-0001-8857-7389

Article

Publisher ID: 57647

DOI: 10.1038/s41598-020-57647-x

PMC ID: 7239869

PubMed ID: 32433470

SO-VID: d830793a-0576-4b91-9a10-6b80561bc773

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 4 November 2018

Date accepted : 9 December 2019

Funding

Funded by: FundRef https://doi.org/10.13039/501100003061, Erasmus Medisch Centrum (Erasmus Medical Center);

Award ID: Koers18-Prevention

Award Recipient : Suzanne Polinder

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ScienceOpen disciplines: Uncategorized

Keywords: depression,preventive medicine,epidemiology,outcomes research,preclinical research

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ScienceOpen disciplines: Uncategorized

Keywords: depression, preventive medicine, epidemiology, outcomes research, preclinical research

Anxiety and depression in diabetes care: longitudinal associations with health-related quality of life

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Most cited references 34

Bidirectional Association Between Depression and Metabolic Syndrome

Diabetes, depression, and quality of life: a population study.

The utility of 'country of birth' for the classification of ethnic groups in health research: the Dutch experience.

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