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

Autor: Whitworth SR; School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia. Electronic address: stephanie.whitworth@research.uwa.edu.au., Bruce DG; School of Medicine & Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia., Starkstein SE; School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia., Davis WA; School of Medicine & Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia., Davis TM; School of Medicine & Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia., Bucks RS; School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2016 Dec; Vol. 122, pp. 190-197. Date of Electronic Publication: 2016 Nov 09.
DOI: 10.1016/j.diabres.2016.10.023
Abstrakt: Aims: To 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.
Methods: 1285 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.
Results: L-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).
Conclusions: Lifetime 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.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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