Lifetime depression and anxiety increase prevalent psychological symptoms and worsen glycemic control in type 2 diabetes: The Fremantle Diabetes Study Phase II

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Abstract

© 2016 Elsevier Ireland Ltd
AimsTo determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes.
Methods1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration.
ResultsL-MDD and L-GAD were independently associated with more severe current depression (both P < 0.001) and anxiety (both P < 0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA 1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P < 0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA 1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P < 0.001).
ConclusionsLifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes.
Original languageEnglish
Pages (from-to)190-197
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume122
Early online date9 Nov 2016
DOIs
Publication statusPublished - 1 Dec 2016

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Anxiety Disorders
Type 2 Diabetes Mellitus
Anxiety
Depression
Psychology
Major Depressive Disorder
Health Behavior
Blood Glucose Self-Monitoring
Independent Living
Behavior Control
Marital Status
Ireland
Hyperglycemia
Body Mass Index
Smoking
Health

Cite this

@article{9e197a9529bc40679b789e9854c9620f,
title = "Lifetime depression and anxiety increase prevalent psychological symptoms and worsen glycemic control in type 2 diabetes: The Fremantle Diabetes Study Phase II",
abstract = "{\circledC} 2016 Elsevier Ireland LtdAimsTo determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes.Methods1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration.ResultsL-MDD and L-GAD were independently associated with more severe current depression (both P < 0.001) and anxiety (both P < 0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA 1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P < 0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA 1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P < 0.001).ConclusionsLifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes.",
author = "Stephanie Whitworth and David Bruce and Sergio Starkstein and Wendy Davis and Timothy Davis and Romola Bucks",
year = "2016",
month = "12",
day = "1",
doi = "10.1016/j.diabres.2016.10.023",
language = "English",
volume = "122",
pages = "190--197",
journal = "Diabetes Research and Clinical Practice",
issn = "0168-8227",
publisher = "Elsevier",

}

TY - JOUR

T1 - Lifetime depression and anxiety increase prevalent psychological symptoms and worsen glycemic control in type 2 diabetes

T2 - The Fremantle Diabetes Study Phase II

AU - Whitworth, Stephanie

AU - Bruce, David

AU - Starkstein, Sergio

AU - Davis, Wendy

AU - Davis, Timothy

AU - Bucks, Romola

PY - 2016/12/1

Y1 - 2016/12/1

N2 - © 2016 Elsevier Ireland LtdAimsTo determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes.Methods1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration.ResultsL-MDD and L-GAD were independently associated with more severe current depression (both P < 0.001) and anxiety (both P < 0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA 1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P < 0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA 1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P < 0.001).ConclusionsLifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes.

AB - © 2016 Elsevier Ireland LtdAimsTo determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes.Methods1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration.ResultsL-MDD and L-GAD were independently associated with more severe current depression (both P < 0.001) and anxiety (both P < 0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA 1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P < 0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA 1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P < 0.001).ConclusionsLifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes.

U2 - 10.1016/j.diabres.2016.10.023

DO - 10.1016/j.diabres.2016.10.023

M3 - Article

VL - 122

SP - 190

EP - 197

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

ER -