Suicidal ideation in patients with diabetes and childhood abuse - The mediating role of personality functioning: Results of a German representative population-based study.

Journal: Diabetes research and clinical practice

Volume: 210

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany. Electronic address: sandra.zara@psycho.med.uni-giessen.de. Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Baldingerstrasse, Marburg, Germany; German Center for Diabetes Research (DZD), München , Neuherberg, Germany. Department of Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Germany. Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany; German Center for Mental Health (DZPG), partner site Ulm, Germany. German Center for Diabetes Research (DZD), München , Neuherberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany. Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Department of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria. Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany.

Abstract summary 

Suicidal ideation (SID) in patients with diabetes mellitus is increasingly acknowledged. Still, the underlying mechanisms are unclear. We examined SID prevalences in patients with diabetes, its association with different types of abuse, and a mediating effect of personality functioning.In a representative population sample (N = 2,515), diabetes, SID, abuse (ICAST-R), personality functioning (OPD-SQS), and depression/anxiety (PHQ-4) were assessed by self-report. Statistical analyses comprised Chi-Tests, logistic regression and mediation analyses.The prevalence of SID (21.8 %) was three fold higher in patients with diabetes compared to the general population. Abuse further increased the likelihood to report SID in diabetes patients (sexual: 48.1 % vs. 18.2 %; χ = 12.233, p <.001; emotional: 35.7 % vs. 15.7 %; χ = 10.892, p <.001). A dose-response relationship between the number of abuse experiences and SID was observed (one abuse experience: OR = 1.138, 95 %-CI [0.433, 2.990], p =.793, >2 abuse experiences: OR = 2.693, 95 %-CI [1.278, 5.675], p =.009). Impaired personality functioning had an indirect effect on the association between emotional abuse and SID (b = 0.25, 95 %-CI [0.037, 0.551]).Diabetes patients experience increased SID prevalences, especially those with emotional or sexual abuse. In individuals with a history of emotional abuse, impaired personality functioning partly explained SID and should therefore be considered and addressed in this patient group.

Authors & Co-authors:  Zara Kruse Brähler Sachser Fegert Ladwig Ernst Kampling

Study Outcome 

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Statistics
Citations : 
Authors :  8
Identifiers
Doi : 10.1016/j.diabres.2024.111635
SSN : 1872-8227
Study Population
Male,Female
Mesh Terms
Other Terms
Child maltreatment;Diabetes mellitus;Emotional abuse;Mediator;Personality functioning;Suicidal ideation
Study Design
Study Approach
Country of Study
Publication Country
Ireland