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Interaction of Clinical and Subclinical Depressive Disorders with Subjectively Perceived Well-Being, Diabetes Self-Management and Glycemic Control in Type 2 Patients

This study was aimed at exploring interaction of both clinical and subclinical depressive disorders with perceived well-being, diabetes self-management and glycemic control in type 2 patients. The examined sample (N=384) was randomly selected among patients attending their regular check-ups. Information on current life circumstances, family and economic status were collected by a semi-structured interview. Questionnaires assessing depressive symptoms (CES-D), diabetes-related distress (PAID), diabetes self-care (SCDA), quality of life (SF-12) and well-being (WHO-5) were used to gain insight into an individual s emotional state and experience in living with the disease. Patients with CES-D scores 16 were invited to psychiatric interview to assess clinical significance of depressive symptoms. One-way ANOVA was used to compare depression-free patients with those expressing clinically significant and subclinical depression. Chi-square tests were used to compare health-related indicators for the groups with and without depressive symptoms. Twenty-two percent of patients had CES-D scores 16 and among them 33% had clinical depression confirmed by psychiatric interview. Both clinically and subclinically depressed patients, when compared with symptom free patients, expressed more diabetes-related distress and poorer quality of life (F=15.27 p=0.0000 and F=52.19 p=0.0000 respectively). They had poorer adherence to diet (F=2.75 p=0.04), more frequent smoking status (chi =4.87 p=0.02) and higher rates of neuropathy and cardiopathy (chi =3.82 p=0.05 and chi =4.53 p=0.03 respectively). Glycemic control as assessed by HbA1C did not differ between symptom free and depressed patients, neither at the time of examination (F=0.24 p=0.856) nor previously (F=0.72 p=0.539). The collected data indicated that even subclinical depressive disorders in type 2 patients adversely interact with perceived health/well-being and might affect self-care. Both symptom free and depressed patients had comparable glycemic control.

Depression; type 2 diabetes; well-being; glycemic control

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