Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care

Park, Hyesook; Hong, Yong-Kil; Lee, Hye-Jin; Ha, Eun–Hee; Sung, Yeon Ah

doi:10.1016/j.jclinepi.2004.01.015

Cited by 101 publications

(96 citation statements)

References 36 publications

(36 reference statements)

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“…It is important for rheumatologists to consider addressing both the RA and the depression, because research in other chronic disease areas such as diabetes has shown that depression can impact adherence to diabetes medications and self-care regimens (22,23). As illustrated by the transcripts of some of the medical visits in which depression was discussed, sometimes when the patient brought up depression the physician picked up on the discussion of depression, asked questions, and suggested treatment for the patient's depression.…”

Section: Discussionmentioning

confidence: 99%

Communication about depression during rheumatoid arthritis patient visits

Sleath¹,

Chewning²,

Vellis³

et al. 2008

Arthritis & Rheumatism

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Section: Discussionmentioning

confidence: 99%

Communication about depression during rheumatoid arthritis patient visits

Sleath¹,

Chewning²,

Vellis³

et al. 2008

Arthritis & Rheumatism

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“…We analyzed a large primary care sample to examine the relationship between depression and a complete set of self-care behaviors that are important for the management of type 2 diabetes, using a wellvalidated measure (the SDSCA). With one notable exception (7), other studies have tended to focus on either medication adherence (9,10) or a less complete subset of self-care behaviors (5,6) or have used measures of diabetes self-care with unknown reliability and/or validity (8,21). We also relied on a sensitive, wellvalidated, screening instrument (14) to measure depression and examined the impacts of both probable major depression and subclinical symptoms of depression on diabetes self-care behaviors.…”

Section: Self-care Among Patients Not Meeting Criteria For Major Deprmentioning

confidence: 99%

“…The available literature suggests that clinically significant levels of depression are associated with a range of poorer selfcare behaviors including adherence to diet (5)(6)(7)(8), exercise (6,7), and prescribed medications (5,7,9,10). However, although depression is clinically conceptualized as a discrete comorbid illness, few researchers have investigated the possibility of a dose-response relationship between symptoms of depression and poorer self-care, favoring instead a conceptualization of depression as a discrete comorbid illness when examining its relationship to diabetes self-care behaviors.…”

mentioning

confidence: 99%

Depression, Self-Care, and Medication Adherence in Type 2 Diabetes

et al. 2007

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OBJECTIVE -We examined the association between depression, measured as either a continuous symptom severity score or a clinical disorder variable, with self-care behaviors in type 2 diabetes.RESEARCH DESIGN AND METHODS -We surveyed 879 type 2 diabetic patients from two primary care clinics using the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS), the Summary of Diabetes Self-Care Activities, and self-reported medication adherence.RESULTS -Of the patients, 19% met the criteria for probable major depression (HANDS score Ն9), and an additional 66.5% reported at least some depressive symptoms. After controlling for covariates, patients with probable major depression reported significantly fewer days' adherent to diet, exercise, and glucose self-monitoring regimens (P Ͻ 0.01) and 2.3-fold increased odds of missing medication doses in the previous week (95% CI 1.5-3.6, P Ͻ 0.001) compared with all other respondents. Continuous depressive symptom severity scores were better predictors of nonadherence to diet, exercise, and medications than categorically defined probable major depression. Major depression was a better predictor of glucose monitoring. Among the two-thirds of patients not meeting the criteria for major depression (HANDS score Ͻ9, n ϭ 709), increasing HANDS scores were incrementally associated with poorer self-care behaviors (P Ͻ 0.01).CONCLUSIONS -These findings challenge the conceptualization of depression as a categorical risk factor for nonadherence and suggest that even low levels of depressive symptomatology are associated with nonadherence to important aspects of diabetes self-care. Interventions aimed at alleviating depressive symptoms, which are quite common, could result in significant improvements in diabetes self-care. Diabetes Care 30:2222-2227, 2007M ajor depression is a significant problem among patients with diabetes, with an estimated prevalence of 15-20%, compared with 2-9% in the general population (1). Among patients with type 2 diabetes, major depression is associated with a 2.3-fold increase in mortality, and minor or "subclinical" depression is associated with a 1.7-fold increase (2). Depression also increases the risk of poorer diabetes-specific outcomes such as hyperglycemia (3) and an increase in diabetes complications (4).The available literature suggests that clinically significant levels of depression are associated with a range of poorer selfcare behaviors including adherence to diet (5-8), exercise (6,7), and prescribed medications (5,7,9,10). However, although depression is clinically conceptualized as a discrete comorbid illness, few researchers have investigated the possibility of a dose-response relationship between symptoms of depression and poorer self-care, favoring instead a conceptualization of depression as a discrete comorbid illness when examining its relationship to diabetes self-care behaviors.The aim of the current study was to extend previous research by examining the relationships between depression and the full range of diab...

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“…It is very difficult for a patient suffering from both depression and diabetes to practice sports regularly, to take medicines in compliance with the physician's orders or to stop smoking. A direct association between depression and diabetes is constant and independent from socioeconomic status or cultural origin [27,28]. The respondents often visit the physicians in specialist clinics.…”

Section: Discussionmentioning

confidence: 99%