The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes
Abstract
Depressive symptoms are common among patients with diabetes and may have a significant impact on self-management and health outcomes. In this study we predicted that: 1) there would be a significant association between depressive symptoms and diabetes symptom burden, physical functioning, diabetes self-care, and HbA1c levels; and, 2) that the association between depressive symptoms and HbA1c levels would be significantly greater in type 1, as compared to type 2 diabetic patients. This cross-sectional observational study of 276 type 1 and 199 type 2 diabetes patients took place in a tertiary care specialty clinic. We collected self-reported data on depressive symptoms, complications, medical comorbidity, diabetes symptoms, diabetes self-care behaviors, physical functioning, and demographics. From automated data we determined mean HbA1c levels over the prior year. We performed linear regression analyses to assess the association between depressive symptoms and diabetes symptom perception, diabetes self-care behaviors, physical functioning, and glycemic control. Among patients with type 1 and 2 diabetes, depressive symptoms were associated with greater diabetes symptom reporting, poorer physical functioning, and less adherence to exercise regimens and diet. There was a significant association between depressive symptoms and HbA1c levels in type 1, but not type 2 diabetic patients. Because of their association with clinical aspects of diabetes care such as diabetes symptom reporting and adherence to diabetes self-care, depressive symptoms are important to recognize in treating patients with diabetes.
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In people newly diagnosed with HIV, positive affect prospectively predicts greater engagement in care and better medication adherence.
“Research on individuals newly diagnosed with HIV indicates that positive affect prospectively predicts greater liklihood of engagement in care and better medication adherence [11].”
From An online positive affect skills intervention reduces depression in adults with type 2 diabetes (2014) · cites this paper as [11]
Cites
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory
Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974) · Behavioral Science · doi:10.1002/bs.3830190102 · Cited by 4,604 · see citing works
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.14.2101 · Cited by 4,177 · see citing works
The Prevalence of Comorbid Depression in Adults With Diabetes
Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001) · Diabetes Care · doi:10.2337/diacare.24.6.1069 · Cited by 3,926 · see citing works
Depression and poor glycemic control: a meta-analytic review of the literature.
Lustman, P. J., Anderson, R. J., Freedland, K. E., de Groot, M., Carney, R. M., & Clouse, R. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.7.934 · Cited by 1,854 · see citing works
Depression and Diabetes: Impact of Depressive Symptoms on Adherence, Function, and Costs
Ciechanowski, P. S., Katon, W. J., & Russo, J. E. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.21.3278 · Cited by 1,465 · see citing works
Self-citationCollaborative management to achieve treatment guidelines. Impact on depression in primary care
Katon, W. J. (1995) · JAMA · doi:10.1001/jama.273.13.1026 · Cited by 1,464 · see citing works
Self-citationWells, K. B., Sherbourne, C., Schoenbaum, M., Duan, N., Meredith, L., Unützer, J., Miranda, J., Carney, M. F., & Rubenstein, L. V. (2000) · JAMA · doi:10.1001/jama.283.2.212 · Cited by 1,021 · see citing works
Egede, L. E., Zheng, D., & Simpson, K. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.464 · Cited by 816 · see citing works
Handbook of Psychology and Diabetes
Bradley, C. (2013) · Routledge eBooks · doi:10.4324/9781315077369 · Cited by 668 · see citing works
Lustman, P. J., Griffith, L. S., Freedland, K. E., Kissel, S. S., & Clouse, R. E. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-129-8-199810150-00005 · Cited by 562 · see citing works
The Hopkins Symptom Checklist (HSCL)
Lipman, R. S., Covi, L., & Shapiro, A. K. (1979) · Journal of Affective Disorders · doi:10.1016/0165-0327(79)90021-1 · Cited by 559 · see citing works
Impact of major depression on chronic medical illness
Katon, W., & Ciechanowski, P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00313-6 · Cited by 485 · see citing works
Self-citationWilliams, Jr., Barrett, J., Oxman, T., Frank, E., Katon, W., Sullivan, M., Cornell, J., & Sengupta, A. (2000) · JAMA · doi:10.1001/jama.284.12.1519 · Cited by 460 · see citing works
Self-citationCase-Finding Instruments for Depression in Primary Care Settings
Mulrow, C. D., Williams, J. W., Gerety, M. B., Ramirez, G., Montiel, O. M., & Kerber, C. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-12-199506150-00004 · Cited by 456 · see citing works
Fluoxetine for depression in diabetes: a randomized double-blind placebo-controlled trial.
Lustman, P. J., Freedland, K. E., Griffith, L. S., & Clouse, R. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.5.618 · Cited by 445 · see citing works
A Comparison of Two Psychiatric Screening Tests
Goldberg, D. P., Rickels, K., Downing, R. W., & Hesbacher, P. T. (1976) · The British Journal of Psychiatry · doi:10.1192/bjp.129.1.61 · Cited by 400 · see citing works
Assessing diabetes self-management: The Summary of Diabetes Self-Care Activities Questionnaire.
Toobert, D. J., & Glasgow, R. E. (1994) · Cited by 265 · see citing works
The Diabetes Control and Complications Trial Research Group (1996) · Diabetes Care · doi:10.2337/diacare.19.3.195 · Cited by 246 · see citing works
Depression in adults with diabetes. Results of 5-yr follow-up study
Lustman, P. J., Griffith, L. S., & Clouse, R. E. (1988) · Diabetes Care · doi:10.2337/diacare.11.8.605 · Cited by 234 · see citing works
Insulin resistance after oral glucose tolerance testing in patients with major depression
Winokur, A., Maislin, G., Phillips, J. L., & Amsterdam, J. D. (1988) · American Journal of Psychiatry · doi:10.1176/ajp.145.3.325 · Cited by 203 · see citing works
Major Depressive Disorder in Youths With IDDM: A controlled prospective study of course and outcome
Kovács, M., Obrosky, D. S., Goldston, D. B., & DRASH, A. L. (1997) · Diabetes Care · doi:10.2337/diacare.20.1.45 · Cited by 191 · see citing works
Jacobson, A. M., de Groot, M., & SAMSON, J. A. (1997) · Quality of Life Research · doi:10.1023/a:1026487509852 · Cited by 170 · see citing works
Depressed Mood Is a Factor in Glycemic Control in Type 1 Diabetes
van Tilburg, M. A. L., McCaskill, C. C., Lane, J. D., Edwards, C. L., Bethel, A., Feinglos, M. N., & Surwit, R. S. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200107000-00005 · Cited by 153 · see citing works
Relationship of Self-efficacy and Binging to Adherence to Diabetes Regimen Among Adolescents
Littlefield, C. H., Craven, J. L., Rodin, G., Daneman, D., Murray, M. A., & Rydall, A. C. (1992) · Diabetes Care · doi:10.2337/diacare.15.1.90 · Cited by 150 · see citing works
Psychiatric Screening in a Medical Clinic
Glass, R. M. (1978) · Archives of General Psychiatry · doi:10.1001/archpsyc.1978.01770340039003 · Cited by 136 · see citing works
Depression and the Reporting of Diabetes Symptoms
Lustman, P. J., Clouse, R. E., & Carney, R. M. (1989) · The International Journal of Psychiatry in Medicine · doi:10.2190/lw52-jfkm-jchv-j67x · Cited by 93 · see citing works
Jacobson, A. M., Rand, L. I., & Hauser, S. T. (1985) · Psychosomatic Medicine · doi:10.1097/00006842-198507000-00007 · Cited by 59 · see citing works
Management of Major Depression in Adults With Diabetes: Implications of Recent Clinical Trials.
Lustman, Clouse, & Freedland (1998) · PubMed · Cited by 55 · see citing works
A new self-completion outcome measure for diabetes: is it responsive to change?
Whitty, P., Steen, N., Eccles, M., McColl, E., Hewison, J., Meadows, K., Clapp, Z., & Hutchinson, A. (1997) · Quality of Life Research · doi:10.1023/a:1018443628933 · Cited by 43 · see citing works
The Effect of Major Depression on Chronic Medical Illness.
Katon, W. J. (1998) · PubMed · Cited by 23 · see citing works
Self-citation
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Cited by
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Epidemiology of depression and diabetes: a systematic review
Roy, T., & Lloyd, C. E. (2012) · Journal of Affective Disorders · doi:10.1016/s0165-0327(12)70004-6 · Cited by 1,229 · see citing works
Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
Gonzalez, J. S., Peyrot, M., McCarl, L. A., Collins, E. M., Serpa, L., Mimiaga, M. J., & Safren, S. A. (2008) · Diabetes Care · doi:10.2337/dc08-1341 · Cited by 1,060 · see citing works
Mood disorders in the medically ill: scientific review and recommendations
Evans, D. L., Charney, D. S., Lewis, L., Golden, R. N., Gorman, J. M., Krishnan, K. R. R., Nemeroff, C. B., Bremner, J. D., Carney, R. M., Coyne, J. C., et al. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.05.001 · Cited by 1,071 · see citing works
Self-citationKaton, W., Lin, E. H. B., & Kroenke, K. (2007) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2006.11.005 · Cited by 965 · see citing works
Self-citationJoseph, J. J., & Golden, S. H. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13217 · Cited by 574 · see citing works
Depression, Self-Care, and Medication Adherence in Type 2 Diabetes
Gonzalez, J. S., Safren, S. A., Cagliero, E., Wexler, D. J., Delahanty, L., Wittenberg, E., Blais, M. A., Meigs, J. B., & Grant, R. W. (2007) · Diabetes Care · doi:10.2337/dc07-0158 · Cited by 579 · see citing works
Gehi, A., Haas, D., Pipkin, S., & Whooley, M. A. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.21.2508 · Cited by 488 · see citing works
Depression in type 2 diabetes mellitus: prevalence, impact, and treatment
Semenkovich, K., Brown, M. E., Svrakic, D. M., & Lustman, P. J. (2015) · Drugs · doi:10.1007/s40265-015-0347-4 · Cited by 447 · see citing works
A Review of Treating Depression in Diabetes: Emerging Findings
Markowitz, S. M., Gonzalez, J. S., Wilkinson, J. L., & Safren, S. A. (2011) · Psychosomatics · doi:10.1016/j.psym.2010.11.007 · Cited by 230 · see citing works
Symptoms of depression prospectively predict poorer self‐care in patients with Type 2 diabetes
Gonzalez, J. S., Safren, S. A., Delahanty, L. M., Cagliero, E., Wexler, D. J., Meigs, J. B., & Grant, R. W. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02535.x · Cited by 192 · see citing works
Positive affect uniquely predicts lower risk of mortality in people with diabetes.
Moskowitz, J. T., Epel, E. S., & Acree, M. (2008) · Health Psychology · doi:10.1037/0278-6133.27.1.s73 · Cited by 191 · see citing works
An online positive affect skills intervention reduces depression in adults with type 2 diabetes
Cohn, M. A., Pietrucha, M. E., Saslow, L. R., Hult, J. R., & Moskowitz, J. T. (2014) · The Journal of Positive Psychology · doi:10.1080/17439760.2014.920410 · Cited by 188 · see citing works
Ali, S., Stone, M., Skinner, T. C., Robertson, N., Davies, M., & Khunti, K. (2010) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1065 · Cited by 186 · see citing works
Das-Munshi, J., Stewart, R., Ismail, K., Bebbington, P. E., Jenkins, R., & Prince, M. J. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3180cc3062 · Cited by 183 · see citing works
Lin, E. H. B., Von Korff, M., Ciechanowski, P., Peterson, D., Ludman, E. J., Rutter, C. M., Oliver, M., Young, B. A., Gensichen, J., McGregor, M., et al. (2012) · The Annals of Family Medicine · doi:10.1370/afm.1343 · Cited by 150 · see citing works
Self-citationVileikyte, L., Peyrot, M., Gonzalez, J. S., Rubin, R. R., Garrow, A. P., Stickings, D., Waterman, C., Ulbrecht, J. S., Cavanagh, P. R., & Boulton, A. J. M. (2009) · Diabetologia · doi:10.1007/s00125-009-1363-2 · Cited by 123 · see citing works
Changes in depressive symptoms and glycemic control in diabetes mellitus
Georgiades, A., Zucker, N., Friedman, K. E., Mosunic, C. J., Applegate, K., Lane, J. D., Feinglos, M. N., & Surwit, R. S. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318042588d · Cited by 99 · see citing works
Katon, W., Lin, E. H. B., Von Korff, M., Ciechanowski, P., Ludman, E., Young, B., Rutter, C., Oliver, M., & McGregor, M. (2010) · Contemporary Clinical Trials · doi:10.1016/j.cct.2010.03.009 · Cited by 100 · see citing works
Rees, C. A., Karter, A. J., & Young, B. A. (2010) · The Diabetes Educator · doi:10.1177/0145721710364419 · Cited by 83 · see citing works
Approach to the Patient with Multiple Somatic Symptoms
Croicu, C., Chwastiak, L., & Katon, W. (2014) · Medical Clinics of North America · doi:10.1016/j.mcna.2014.06.007 · Cited by 81 · see citing works
Self-citationCoping and positive affect predict longitudinal change in glycosylated hemoglobin.
Tsenkova, V. K., Dienberg Love, G., Singer, B. H., & Ryff, C. D. (2008) · Health Psychology · doi:10.1037/0278-6133.27.2(suppl.).s163 · Cited by 69 · see citing works
Positive Psychological Characteristics in Diabetes: A Review
Celano, C. M., Beale, E. E., Moore, S. V., Wexler, D. J., & Huffman, J. C. (2013) · Current Diabetes Reports · doi:10.1007/s11892-013-0430-8 · Cited by 69 · see citing works
Lifetime duration of depressive disorders in patients with type 2 diabetes
de Groot, M., Crick, K. A., Long, M., Saha, C., & Shubrook, J. H. (2016) · Diabetes Care · doi:10.2337/dc16-1145 · Cited by 54 · see citing works
Barriers to achieving glycemic targets: who omits insulin and why?
Weinger, K., & Beverly, E. A. (2010) · Diabetes Care · doi:10.2337/dc09-2132 · Cited by 53 · see citing works
Fitzpatrick, S. L., Golden, S. H., Stewart, K., Sutherland, J., DeGross, S., Brown, T., Wang, N.-Y., Allen, J., Cooper, L. A., & Hill-Briggs, F. (2016) · Diabetes Care · doi:10.2337/dc16-0941 · Cited by 49 · see citing works
Pharmacist-led telehealth disease management program for patients with diabetes and depression
Cohen, L. B., Taveira, T. H., Wu, W.-C., & Pirraglia, P. A. (2020) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x18822575 · Cited by 48 · see citing works
Bolge, S. C., Flores, N. M., & Phan, J. H. (2016) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000000874 · Cited by 14 · see citing works
Sweet sins: frequency and psychiatric motivation for theft among adolescents with type 1 diabetes
Butwicka, A., Fendler, W. M., Zalepa, A., Szadkowska, A., Gmitrowicz, A., & Młynarski, W. M. (2011) · Pediatric Diabetes · doi:10.1111/j.1399-5448.2010.00721.x · Cited by 6 · see citing works
- Authors
- Ciechanowski, P. S., Katon, W. J., Russo, J. E., & Hirsch, I. B.
- Affiliations
- University of Washington (US)
- Corresponding author
- Ciechanowski, Paul S
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 25
- Issue
- 4
- Pages
- 246-252
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2081566878
- Cited by
- 428
- References
- 32
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 16 · 2020: 11 · 2019: 12 · 2018: 13 · 2017: 7 · 2016: 17 · 2015: 23 · 2014: 28 · 2013: 17 · 2012: 38
- FWCI
- 13.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK060652, K23 DK60652-01)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- depressive symptoms, diabetes mellitus, type 1 diabetes, type 2 diabetes, glycemic control, HbA1c, diabetes self-care, physical function, exercise adherence, dietary adherence, symptom reporting
- MeSH terms
- Adolescent, Adult, Aged, Blood Glucose, Cross-Sectional Studies, Depression, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Self Care, Washington, Sickness Impact Profile
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