Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study.
Journal: Epidemiology and psychiatric sciences
Volume: 29
Issue:
Year of Publication: 2020
Affiliated Institutions:
The Open University, Milton Keynes, UK.
Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
Child Adolescent & Family Psychiatry, National Institute of Mental Health (NIMH), Dhaka, Bangladesh.
Servicio de Endocrinologia y Medicina Nuclear del Hospital Italiano de Buenis Aires, Buenis Aires, Argentina.
The Mother Kevin Post Graduate Medical School, Uganda Martyrs University, Kampala, Uganda.
Federal Medical Research Centre for Psychiatry and Narcology, Moscow, Russia.
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
National Institute of Mental Health & Neurosciences, Bangalore, India.
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
European Psychiatric Association - Early Career Psychiatrists Committee, Wroclaw, Poland.
Servicio de Psiquiatría del Hospital Italiano de Buenos Aires, Buenis Aires, Argentina.
Universidad Nacional Autónoma de México, Mexico City, Mexico.
Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
WSB University, Toruń, Poland.
II Department of Psychiatry, Medical University of Warsaw, Warszawa, Poland.
Diabetes Centre and Jnana Sanjeevini Medical Centre, Bangalore, India.
Clinic for Endocrinology, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Diabetology - Careggi Teaching Hospital and University of Florence, , Florence, Italy.
Department of Diabetology, National Medical Academy for Postgraduate Education, Kyiv, Ukraine.
Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
University of Nairobi, Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
Middlesex University, London, UK.
Neurodevelopmental Protection Trustee Board, Dhaka, Bangladesh.
Samatvam Endocrinology Diabetes Centre and Jnana Sanjeevini Medical Centre, Bangalore, India.
Department of Endocrinology, Moscow Regional Clinical and Research Institute, Moscow, Russia.
Diabetology Unit, ASST Spedali Civili, Brescia, Italy.
School of Medicine, University of Belgrade, Institute of Mental Health, Belgrade, Serbia.
Abstract summary
To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries.People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.
Authors & Co-authors:
Lloyd
Sartorius
Ahmed
Alvarez
Bahendeka
Bobrov
Burti
Chaturvedi
Gaebel
de Girolamo
Gondek
Guinzbourg
Heinze
Khan
Kiejna
Kokoszka
Kamala
Lalic
Lecic-Tosevski
Mannucci
Mankovsky
Müssig
Mutiso
Ndetei
Nouwen
Rabbani
Srikanta
Starostina
Shevchuk
Taj
Valentini
van Dam
Vukovic
Wölwer
Study Outcome
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