Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO Study. Functional status, health service use and treatment of people with depressive symptoms

Herrman, Helen; Patrick, Donald L.; Diehr, Paula; Martin, Mona L.; Fleck, Marcelo P.; Simon, Gregory E.; Buesching, Don P.

doi:10.1017/s003329170200586x

Cited by 182 publications

(171 citation statements)

References 34 publications

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“…There is debate about the utility and costs of screening for depression in the primary care setting (23). However, our findings showing that even subclinical depressive symptoms are associated with nonadherence and previous findings showing that subsyndromal depression is associated with adverse health outcomes such as functional impairments (24) and cardiac mortality (25) underscore the need for increased attention to depression in these patients.…”

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

confidence: 59%

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

confidence: 59%

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

et al. 2007

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“…Australian Bureau of Statistics, 1998;Herrman et al 2002). The instrument has two summary scales, the 'Physical Component Summary ' (PCS-12), an index of physical health and well-being, and the 'Mental Component Summary' (MCS-12), an index of mental health and well-being .…”

Section: Instrumentsmentioning

confidence: 99%

Psychological health of Australian veterans of the 1991 Gulf War: an assessment using the SF-12, GHQ-12 and PCL-S

et al. 2004

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“…13,21,[23][24][25][26] Despite this evidence, depression, like other mental disorders, is often not deemed to be on a par with other chronic physical health conditions in terms of its eff ect on overall health. 27,28 This view is perhaps one of the underlying reasons behind the lack of parity between mental and physical disorders in terms of access to health care.…”

Section: Introductionmentioning

confidence: 99%