Comparative study of the influence of diabetes distress and depression on treatment adherence in Chinese patients with type 2 diabetes: a cross-sectional survey in the People’s Republic of China

Abstract

BackgroundThe purpose of this study was to explore diabetes-related distress and depression and their influence on treatment adherence in Chinese patients with type 2 diabetes.MethodsWe surveyed 200 type 2 diabetic patients from two public hospitals using the Diabetes Distress Scale (DDS), Zung Self-rating Depression Scale, and Revised Treatment Adherence in Diabetes Questionnaire (RADQ). A multiple regression model was used to explore the relationship between diabetes distress, depression, and treatment adherence.ResultsIn the 200 eligible patients, the incidence of depression and diabetes distress was approximately 24% and 64%, respectively. The mean score on the RADQ was 23.0 ± 6.0. Multiple regression analysis showed that DDS scores (β = 5.34, P = 0.000), age (β = 0.15, P = 0.014), and family history (β = 3.2, P = 0.016) had a positive correlation with depression. DDS scores (β = −2.30, P = 0.000) and treatment methods (β = −0.93, P = 0.012) were risk factors for poor treatment adherence, whereas age (β = 0.089, P = 0.000) and cohabitation (β = 0.93, P = 0.012) increased treatment adherence. The independent-samples t- test showed that depression also affected treatment adherence (t = 2.53, P < 0.05).ConclusionThese findings suggest that the DDS is a predictor of depression and that diabetes distress plays a more important part than depression in treatment adherence. Screening for diabetes distress may be useful for primary prevention of psychologic problems; however, some form of specialized psychologic intervention should be incorporated to promote patient adherence with treatment.

Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia

“…DRD prevalence was much lower in study among the native Dutch T2DM patients (primary care 4%, hospital 13%) but similar to the minority of the non-native Dutch patients (55% Turkish, 40% Suriname and 23% other ethnics) [ 18 ]. In mainland China, the prevalence of DRD was 64% among the T2DM patients at two public hospitals [ 35 ]. The prevalence of DRD or/and depression in this study was almost doubled compared to the diabetes outpatient clinic at the University Medical Center Groningen in The Netherlands [ 47 ].…”

“…For example in Australia and Malaysia, female gender [ 15 , 33 ] was associated with general stress; in US, young age, low education levels, low household income, obesity, current smoking, no leisure-time physical activity and presence of one or more micro- or macro-vascular complications were associated with distress [ 34 ]. In China [ 35 ], DRD and older age were associated with depression. In a Malaysian study a family history of psychiatric illnesses, current alcohol drinking, and Indian ethnicity were associated with depression and stress [ 15 ].…”

Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes

“…Quality of life was measured using the Diabetes Specificity Quality of Life Scale (DSQL), which is a validated questionnaire developed by Chen et al [ 28 ]. to assess life quality of type 2 diabetes patients in China.…”

Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional&nbsp;study

“… 10 Other possible reasons include financial constraints and poor social support for refilling prescriptions, 8 , 11 physical and psychological restrictions affecting daily adherence to prescribed medications, and in particular, increased comorbidity, 12 such as complications of T2D, 11 visual impairment, diabetic foot problems, health literacy, 13 cognitive decline, 14 DRD, and depression. 15 Physician characteristics and health care settings are other potential factors that may affect patient participation in decision-making 16 , 17 and MA. 18 , 19 …”