Depression in adults with type 2 diabetes: The role of adherence, body mass index, and self-efficacy.

Abstract

Considerable evidence links depression with the development and worsening of diabetes, but the factors contributing to this link have not been established. The authors examined the role of adherence, body mass index (BMI), and self-efficacy. Adult patients with Type 2 diabetes (N = 56) completed self-report measures of diet and exercise adherence, diet and exercise self-efficacy, and depression. BMI was obtained from medical records. Path and mediation analyses indicated that both adherence and BMI independently contributed to self-efficacy. Self-efficacy mediated both the association between adherence and depression and the association between BMI and depression. These findings are consistent with the proposal that lower self-efficacy in reaction to adherence failure and higher BMI contributes to depression in adults with diabetes.

Psychological distress, self-efficacy and glycemic control in type 2 diabetes

“…Indeed, compared to some previous studies [23], the studies by Talbot et al [12], Sacco et al [15] and Cherrington et al [17] have employed, as it is the case of our study, specific scores on diabetes self-management to assess diabetes-specific self-efficacy. Therefore, it is highly probable that "diabetes-specific" self-efficacy may be stronger than the "general" self-efficacy as a predictor of glycemic control.…”

“…With respect to the association between self-efficacy and glycemic control, previous studies have shown mixed results, spanning from absent [23,24] to strong association [12,15,17], possibly depending on the tools employed to ascertain self-efficacy. Indeed, compared to some previous studies [23], the studies by Talbot et al [12], Sacco et al [15] and Cherrington et al [17] have employed, as it is the case of our study, specific scores on diabetes self-management to assess diabetes-specific self-efficacy.…”

“…Not surprisingly, several studies highlighted diabetesrelated self-efficacy as a potential mediator between depression and glycemic control [15,17]. However, the extent of depression, anxiety, self-efficacy and diabetesspecific psychological measures, and their association with anthropometric and metabolic parameters in patients with T2D have been explored only in part and with conflicting results [4e8].…”

“…Of note, while the association of increased psychological distress (i.e., depression and anxiety) with poorer clinical outcomes in patients with diabetes has some supportive evidence [13,14], higher levels of diabetesrelated self-efficacy [15] and increased social support by family [16] have been associated with improved glucose control and increased engagement in self-management. On the contrary, a lower degree of self-efficacy has been associated with increased depressive symptoms, poorer glycemic control and reduced engagement in self-care behaviors in T2D patients [17].…”

Depression and Diabetes Treatment Nonadherence: A Meta-Analysis

“…One study reported both selfreported and caregiver reported data for depression and self-care; we used selfreported data for the analysis (12). Where two papers were published from samples that were not independent, we included the article with the stronger design: longitudinal over cross-sectional (13,14) or larger sample (15,16). Finally, one study measured depression as both a diagnosis based on structured interview and as a comparison based on the total score from the Centers for Epidemiological Studies Depression Scale (CESD) using two different cutoffs (16 or 22) (17).…”