Prevalence of anxiety in adults with diabetes
Abstract
Background Anxiety is associated with decreased functioning and quality of life. It may have added importance in diabetes for its potential adverse effects on regimen adherence and glycemic control.Objective To estimate the prevalence of clinically significant anxiety in adults with diabetes.Research design and methods MEDLINE and PsycINFO databases and published reference lists were searched to identify studies that determined the prevalence of anxiety in diabetes from threshold scores on self-report measures or from diagnostic interviews. Prevalence was calculated as an aggregate mean weighted by the combined number of subjects in the included studies.Results Eighteen studies having a combined population (N) of 4076 (2584 diabetic subjects, 1492 controls) satisfied the inclusion criteria. Most did not adjust for the effects of moderator variables such as gender, and only one was community-based. Generalized anxiety disorder (GAD) was present in 14% of patients with diabetes. The subsyndromal presentation of anxiety disorder not otherwise specified and of elevated anxiety symptoms were found in 27% and 40%, respectively, of patients with diabetes. The prevalence of elevated symptoms was significantly higher in women compared to men (55.3% vs. 32.9%, P<.0001) and similar in patients with Type 1 vs. Type 2 diabetes (41.3% vs. 42.2%, P=.80).Conclusion GAD is present in 14% and elevated symptoms of anxiety in 40% of patients with diabetes who participate in clinical studies. Additional epidemiological studies are needed to determine the prevalence of anxiety in the broader population of persons with diabetes.
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High depressive affect in patients with diabetes is often not clinical depression but instead diabetes-related emotional distress.
“Previous studies have shown that most patients with diabetes who display high levels of depressive affect are not necessarily clinically depressed 1, 2; instead, they experience high levels of emotional distress stemming from concerns and worries associated with their diabetes and its management 1,3.”
From Predicting diabetes distress in patients with Type 2 diabetes: a longitudinal study (2009) · cites this paper as [2]
Previous reports suggested that most patients with high depressive affect are not necessarily clinically depressed but instead suffer from high diabetes-related distress.
“Previous reports have suggested that most patients with high depressive affect are not necessarily clinically depressed, but rather, are suffering from high levels of diabetes-related distress [5,6]”
From A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes (2008) · cites this paper as [6]
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- Authors
- Grigsby, A. B., Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Lustman, Patrick J
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2002-12
- Volume
- 53
- Issue
- 6
- Pages
- 1053-1060
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W1986668408
- Cited by
- 609
- References
- 78
- Citations by year
- 2026: 21 · 2025: 30 · 2024: 27 · 2023: 26 · 2022: 36 · 2021: 44 · 2020: 38 · 2019: 24 · 2018: 31 · 2017: 25 · 2016: 44 · 2015: 35 · 2014: 34 · 2013: 32 · 2012: 29
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01dk053060-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK59364, DK-36452, DK20579, DK53060, K24DK059364, R01DK036452)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- anxiety, diabetes mellitus, prevalence, generalized anxiety disorder, type 1 diabetes, type 2 diabetes, sex differences, glycemic control, medication adherence, quality of life
- MeSH terms
- Adult, Aged, Anxiety Disorders, Clinical Trials as Topic, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Severity of Illness Index, Prevalence, Epidemiologic Studies, Diabetes Complications
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