engleski

Determinants of recovery from depression in type 2 diabetic patients after a one-year follow-up

Background and aims: Little is known about the course of depressive symtoms in type 2 diabetic patients. This study was aimed at exploring changes in depressive symptoms after one year follow-up, and determining factors that may predict them. Materials and methods: One hundred patients found to be at risk for depression by using CES-D scale in a random sample of 463 type patients, among them 30 diagnosed with clinical depression using structured clinical interview, were followed for one year. Problem areas in diabetes scale (PAID) and health-related quality of life measure (SF-12) were applied in addition to CES-D. Initially informed about their condition and treatment possibilities, the patients were contacted by phone at 3-month intervals, and re-assessed for depression after one year. They were aged 57&plusmn ; ; ; 7 yrs, with diabetes duration of 9&plusmn ; ; ; 6 yrs ; 66% were female and 44% were on insulin therapy. Changes in depressive symptoms were determined using t-test. A reduction in depressive symptoms from CES-D&#8805; 16 to CES-D< 16 was taken as being indicative of recovery, with multiple regression analysis used to determine its predictors. Results: Fifty-six percent of patients with baseline CES-D scores &#8805; 16 improved their depressive symptoms after one year and were below this cut-off (CES-D=9.8&plusmn ; ; ; 3.6), while 44% remained in the category indicative of pervasive depression (CES-D=27.3&plusmn ; ; ; 8.4). Regression summary for CES-D group (<16 vs. &#8805; 16) as a dependent variable indicated that some demographic and psychological variables may predict recovery from depression (R=0.679 R&sup2 ; ; ; =0.461 F=4.432 p<0.00008). Social functioning as assessed by SF-12, type of depression, gender, the PAID score, physical functioning and age were shown to be the strongest individual predictors of depressive symptoms at one-year follow-up (Beta's were -0.48, 0.33, -0.30, 0.27, -0.300 and 0.25, respectively ; all p<0.05). Patients more disturbed in social functioning, clinically depressed, male, of older age, with more diabetes-related emotional problems and worse physical functioning, were shown to have more difficulties in achieving recovery from depression. Conclusion: The results suggest that some subgroups are more vulnerable to persistent depression and may need stronger support. Addressing diabetes-related emotional problems may be helpful in facilitating recovery from depression.

type 2 diabetes; depression; persistence of depression

Sažetak je objavljen u suplementu DIABETOLOGIA, časopisu europskog udruženja za istraživanje dijabetesa (EASD)