Affective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factors
Abstract
Aims The aims of this study were to examine (1) the prevalence of clinical and subclinical anxiety and affective disorders in a sample of diabetic patients attending a secondary care clinic in Germany and (2) risk factors associated with the occurrence of these disorders. Methods Four hundred and twenty diabetic patients (36.9% Type 1; 24.7% Type 2; 38.4% Type 2 with insulin) participated in a questionnaire‐based screening survey. Those who screened positive received a diagnostic interview. Results Prevalence of clinical affective disorders was 12.6%, with an additional 18.8% of patients reporting depressive symptoms without fulfilling all criteria for a clinical affective disorder. The prevalence of anxiety disorders was 5.9%, with an additional 19.3% of patients reporting some anxiety symptoms. The comorbidity rate of affective and anxiety disorders was 1.8%, whereas 21.4% of the diabetic patients reported elevated affective as well as anxiety symptomatology. Logistic regression established demographic variables such as age, female gender and living alone as well as diabetes‐specific parameters such as insulin treatment in Type 2 diabetes, hypoglycaemia problems and poor glycaemic control as risk factors for affective disorders. For anxiety symptoms female gender, younger age and Type 2 diabetes were significant independent variables. Conclusion The prevalence of affective disorders in diabetic patients was twofold higher than in the non‐diabetic population, whereas prevalence for anxiety disorders was not increased. Analysis of risk factors can facilitate the identification of patients who are at a greater risk for these disorders.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Depression and anxiety symptoms are twice as prevalent among people with type 1 diabetes relative to people without diabetes, negatively impacting quality of life.
“Depression and anxiety symptoms are twice as prevalent among people with type 1 diabetes relative to people without diabetes, negatively impacting quality of life (171-173).”
Several studies have shown negative associations between anxiety disorders and HbA1c.
“several studies have shown negative associations with HbA1c [7,8]”
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 [8]
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Siegel, L. J., & Fletcher‐Janzen, E. (2008) · Wiley eBooks · doi:10.1002/9780470373699.speced0655 · Cited by 8,468 · 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
Wittchen, H.-U. (1994) · Journal of Psychiatric Research · doi:10.1016/0022-3956(94)90036-1 · Cited by 2,348 · 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
Association of depression and diabetes complications: a meta-analysis
de Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200107000-00015 · Cited by 1,799 · 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
Egede, L. E., Zheng, D., & Simpson, K. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.464 · Cited by 816 · see citing works
Das State-Trait-Angstinventar (STAI) : theoretische Grundlagen und Handanweisung
Laux, L. (1981) · Beltz eBooks · Cited by 750 · see citing works
Cross-national comparisons of the prevalences and correlates of mental disorders.
Andrade, L. H., Caraveo-Anduaga, J. J., Berglund, P. A., Bijl, R. C., Kessler, R. C., Demler, O., Walters, E. E., Kylyc, C., Offord, D. R., Üstün, T. B., et al. (2000) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 648 · see citing works
Prevalence of anxiety in adults with diabetes
Grigsby, A. B., Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00417-8 · Cited by 609 · see citing works
Black, S. A., Markides, K. S., & Ray, L. A. (2003) · Diabetes Care · doi:10.2337/diacare.26.10.2822 · Cited by 587 · 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
Levels and risks of depression and anxiety symptomatology among diabetic adults
Peyrot, M., & Rubin, R. R. (1997) · Diabetes Care · doi:10.2337/diacare.20.4.585 · Cited by 488 · see citing works
Roy-Byrne, P. P., Stang, P., Wittchen, H.-U., Ustun, B., Walters, E. E., & Kessler, R. C. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.3.229 · Cited by 446 · 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 review of the relationship between depression and diabetes in adults: is there a link?
Talbot, F., & Nouwen, A. (2000) · Diabetes Care · doi:10.2337/diacare.23.10.1556 · Cited by 410 · see citing works
(1993) · Beltz eBooks · Cited by 409 · see citing works
Effects of Nortriptyline on Depression and Glycemic Control in Diabetes
Lustman, P. J., Griffith, L. S., Clouse, R. E., Freedland, K. E., Eisen, S. A., Rubin, E. H., Carney, R. M., & McGill, J. B. (1997) · Psychosomatic Medicine · doi:10.1097/00006842-199705000-00007 · Cited by 405 · see citing works
Carter, R., Wittchen, H., Pfister, H., & Kessler, R. (2001) · Depression and Anxiety · doi:10.1002/da.1020 · Cited by 345 · see citing works
Anxiety and Poor Glycemic Control: A Meta-Analytic Review of the Literature
Anderson, R. J., Grigsby, A. B., Freedland, K. E., De Groot, M., McGill, J. B., Clouse, R. E., & Lustman, P. J. (2002) · The International Journal of Psychiatry in Medicine · doi:10.2190/klgd-4h8d-4ryl-twq8 · Cited by 328 · see citing works
Screening for Depression in Diabetes Using the Beck Depression Inventory
Lustman, P. J., Clouse, R. E., Griffith, L. S., Carney, R. M., & Freedland, K. E. (1997) · Psychosomatic Medicine · doi:10.1097/00006842-199701000-00004 · Cited by 252 · see citing works
Depression in Adults with Diabetes
Lustman, P. J., Griffith, L. S., Gavard, J. A., & Clouse, R. E. (1992) · Diabetes Care · doi:10.2337/diacare.15.11.1631 · Cited by 235 · see citing works
Pouwer, F., Beekman, A. T. F., Nijpels, G., Dekker, J. M., Snoek, F. J., Kostense, P. J., Heine, R. J., & Deeg, D. J. H. (2003) · Diabetologia · doi:10.1007/s00125-003-1124-6 · Cited by 197 · see citing works
Contributors to Depression in Latino and European-American Patients With Type 2 Diabetes
Fisher, L., Chesla, C. A., Mullan, J. T., Skaff, M. M., & Kanter, R. A. (2001) · Diabetes Care · doi:10.2337/diacare.24.10.1751 · Cited by 170 · see citing works
On the Association Between Diabetes and Mental Disorders in a Community Sample
Kruse, J., Schmitz, N., & Thefeld, W. (2003) · Diabetes Care · doi:10.2337/diacare.26.6.1841 · Cited by 139 · see citing works
Wïttchen, H., Müller, N., Pfister, H., Winter, S., & Schmidtkunz, B. (1999) · Max Planck Institute for Plasma Physics · Cited by 109 · see citing works
Mood changes associated with blood glucose fluctuations in insulin-dependent diabetes mellitus.
Gonder-Frederick, L. A., Cox, D. J., Bobbitt, S. A., & Pennebaker, J. W. (1989) · Health Psychology · doi:10.1037//0278-6133.8.1.45 · Cited by 109 · see citing works
Correlates of hypoglycemic fear in Type I and Type II diabetes mellitus.
Polonsky, W. H., Davis, C. L., Jacobson, A. M., & Anderson, B. J. (1992) · Health Psychology · doi:10.1037//0278-6133.11.3.199 · Cited by 103 · see citing works
Correlates of hypoglycemic fear in Type I and Type II diabetes mellitus.
Polonsky, W. H., Davis, C. L., Jacobson, A. M., & Anderson, B. J. (1992) · Health Psychology · doi:10.1037/0278-6133.11.3.199 · Cited by 94 · see citing works
Mood changes associated with blood glucose fluctuations in insulin-dependent diabetes mellitus.
Gonder-Frederick, L. A., Cox, D. J., Bobbitt, S. A., et al. (1989) · Health Psychology · doi:10.1037/0278-6133.8.1.45 · Cited by 89 · see citing works
Roy‐Byrne, P. (1996) · PubMed · Cited by 86 · see citing works
The epidemiology of comorbidity between depression, anxiety disorders and somatic diseases.
Maier, W., & Falkai, P. (1999) · PubMed · Cited by 85 · see citing works
Association between symptoms of depression and glycaemic control may be unstable across gender
Pouwer, F., & Snoek, F. J. (2001) · Diabetic Medicine · doi:10.1046/j.1464-5491.2001.00499.x · Cited by 74 · see citing works
Furukawa, T., Hirai, T., Kitamura, T., & Takahashi, K. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00079-7 · Cited by 66 · see citing works
Prevalence, recognition, and treatment of comorbid depression and anxiety.
Rapaport, M. H. (2001) · PubMed · Cited by 53 · see citing works
Does Evidence From Clinical Trials in Psychopharmacology Apply in Clinical Practice?
Stahl, S. M. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0102 · Cited by 32 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Holt, R. I. G., DeVries, J. H., Hess-Fischl, A., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, E., et al. (2021) · Diabetes Care · doi:10.2337/dci21-0043 · Cited by 699 · see citing works
Fisher, L., Skaff, M. M., Mullan, J. T., Arean, P., Glasgow, R., & Masharani, U. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02533.x · Cited by 524 · see citing works
Holt, R. I. G., de Groot, M., & Golden, S. H. (2014) · Current Diabetes Reports · doi:10.1007/s11892-014-0491-3 · Cited by 515 · see citing works
Anxiety and depression symptoms in patients with diabetes
Collins, M. M., Corcoran, P., & Perry, I. J. (2009) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02648.x · Cited by 465 · see citing works
“Peyrot and Rubin [23] and Hermanns et al . [ 21 ] used instruments which covered a broader range of symptoms than the HADS instrument.”
MethodConstructs of depression and distress in diabetes: time for an appraisal
Snoek, F. J., Bremmer, M. A., & Hermanns, N. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00135-7 · Cited by 449 · see citing works
Self-citationHolt, R. I. G., DeVries, J. H., Fischl, A. H., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, É., et al. (2021) · Diabetologia · doi:10.1007/s00125-021-05568-3 · Cited by 427 · see citing works
Hermanns, N., Kulzer, B., Krichbaum, M., Kubiak, T., & Haak, T. (2006) · Diabetologia · doi:10.1007/s00125-005-0094-2 · Cited by 324 · see citing works
“The recruitment and reasons for not participating in the second stage of the study are described elsewhere in more detail [15].”
BackgroundSelf-citationInternational Journal of Collaborative Research on Internal Medicine & Public Health
Valdivia, J. R. M. (2021) · Journal of Womens Health Issues and Care · Cited by 300 · see citing works
Psychological conditions in adults with diabetes.
de Groot, M., Golden, S. H., & Wagner, J. (2016) · American Psychologist · doi:10.1037/a0040408 · Cited by 170 · see citing works
Diabetes and psychiatric disorders
Balhara, Y. P. S. (2011) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.85579 · Cited by 166 · see citing works
“[51] Negative correlations have been observed between prevalence of anxiety disorders and levels of HbA1c.”
Pouwer, F., Geelhoed‐Duijvestijn, P. H. L. M., Tack, C. J., Bazelmans, E., Beekman, A. ‐., Heine, R. J., & Snoek, F. J. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2009.02903.x · Cited by 163 · see citing works
Barendse, S., Singh, H., Frier, B. M., & Speight, J. (2012) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03416.x · Cited by 161 · see citing works
Thabrew, H., Stasiak, K., Hetrick, S. E., Wong, S., Huss, J. H., & Merry, S. N. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012489.pub2 · Cited by 141 · see citing works
“[DOI: 10.1002/14651858.CD002317.pub2] Hermanns 2005 Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T. AKective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factors.”
BackgroundInfluentialChew, B., Vos, R. C., Sidik, S. M., & Rutten, G. E. H. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0152095 · Cited by 126 · see citing works
“The most common psychological disorders experienced by adult T2DM patients are diabetes-related distress (DRD) and depressive disorders [14 – 17].”
Screening, evaluation and management of depression in people with diabetes in primary care
Hermanns, N., Caputo, S., Dzida, G. J., Khunti, K., Meneghini, L., & Snoek, F. J. (2012) · Primary care diabetes · doi:10.1016/j.pcd.2012.11.002 · Cited by 119 · see citing works
Self-citationChaturvedi, S. K., Gowda, S. M., Ahmed, H. U., Alosaimi, F. D., Andreone, N., Bobrov, A. E., Bulgari, V., Carrà, G., Castelnuovo, G., de Girolamo, G., et al. (2019) · General Psychiatry · doi:10.1136/gpsych-2019-100076 · Cited by 119 · see citing works
“14 16 More specifically, the prevalence of anxiety symptoms in patients with type 2 diabetes using the Hospital Anxiety and Depression Scale in Pakistan was reported to be around 57.9%, 27 with a much lower prevalence of 9% in Germany.”
BackgroundInfluentialDepression, Anxiety, and Disturbed Sleep in Glaucoma
Agorastos, A., Skevas, C., Matthaei, M., Otte, C., Klemm, M., Richard, G. W., & Huber, C. G. (2013) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.12020030 · Cited by 109 · see citing works
Schunk, M. V., Reitmeir, P., Schipf, S., Völzke, H., Meisinger, C., Thorand, B., Kluttig, A., Greiser, K. H., Berger, K., Müller, G., et al. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03465.x · Cited by 97 · see citing works
Mendes, R., Martins, S. P. V., & Fernandes, L. P. N. S. (2019) · Journal of Clinical Medicine Research · doi:10.14740/jocmr3894 · Cited by 100 · see citing works
“The presence of marked anxiety symptoms may lead to non-adherence [45], in spite of this association not being completely clear and some studies presenting contradictory results, which may be explained by this anxiety symptoms heterogeneity [46, 47, 48].”
ResultPsychotherapy intervention to reduce depressive symptoms in patients with diabetic foot syndrome
Simson, U., Nawarotzky, U., Friese, G., Porck, W., Schottenfeld-Naor, Y., Hahn, S., Scherbaum, W. A., & Kruse, J. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2007.02370.x · Cited by 88 · see citing works
Psychosoziales und Diabetes (Teil 1)
Kulzer, B., Albus, C., Herpertz, S., Kruse, J., Lange, K., Lederbogen, F., & Petrak, F. (2013) · Diabetologie und Stoffwechsel · doi:10.1055/s-0033-1335785 · Cited by 62 · see citing works
Self-citationDepression, Anxiety and Quality of Life among Diabetic Patients: A Comparative Study
Mosaku, K. S., Kolawole, B. A., Mume, C. O., & Ikem, R. T. (2008) · Journal of the National Medical Association · doi:10.1016/s0027-9684(15)31178-0 · Cited by 77 · see citing works
Psychological distress, self-efficacy and glycemic control in type 2 diabetes
Indelicato, L., Dauriz, M., Santi, L., Bonora, F., Negri, C., Cacciatori, V., Targher, G., Trento, M., & Bonora, E. (2017) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2017.01.006 · Cited by 77 · see citing works
“, 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.”
Backgroundon behalf of the Edinburgh Type 2 Diabetes Study Investigators, Labad, J., Price, J. F., Strachan, M. W. J., Fowkes, F. G. R., Ding, J., Deary, I. J., Lee, A. J., Frier, B. M., Seckl, J. R., et al. (2009) · Diabetologia · doi:10.1007/s00125-009-1628-9 · Cited by 71 · see citing works
“Symptoms of anxiety are often reported by people with type 2 diabetes [1], and with depression or obesity [6].”
Association of glucose levels and glucose variability with mood in type 1 diabetic patients
Hermanns, N., Scheff, C., Kulzer, B., Weyers, P., Pauli, P., Kubiak, T., & Haak, T. (2007) · Diabetologia · doi:10.1007/s00125-007-0643-y · Cited by 66 · see citing works
“Negative emotional symptoms such as symptoms of depression or anxiety are more common in diabetic patients than in the non-diabetic population [1–4].”
BackgroundZhu, X., Liu, H., Liu, Y., Chen, Y., Liu, Y., & Yin, X. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.01325 · Cited by 65 · see citing works
Palizgir, M., Bakhtiari, M., & Esteghamati, A. (2013) · Iranian Red Crescent Medical Journal · doi:10.5812/ircmj.12107 · Cited by 61 · see citing works
“Knowledge of disease-specific and nonspecific risk factors facilitates the early identification of people at risk, which is important for further treatments (11).”
BackgroundThabrew, H., Stasiak, K., Hetrick, S. E., Donkin, L., Huss, J. H., Highlander, A., Wong, S., & Merry, S. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012488.pub2 · Cited by 61 · see citing works
“DOI: 10.1002/ 14651858.CD002317.pub2 Hermanns 2005 Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T. Affective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factors.”
BackgroundInfluentialBloomfield, H. E., Greer, N. L., Newman, D. R., MacDonald, R. H., Carlyle, M. H., FITZGERALD, P. J., Rutks, I. R., & Wilt, T. J. (2012) · Cited by 59 · see citing works
Benton, M., Cleal, B., Prina, M., Baykoca, J., Willaing, I., Price, H., & Ismail, K. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2022.11.004 · Cited by 58 · see citing works
Psychosoziales und Diabetes (Teil 2)
Kulzer, B., Albus, C., Herpertz, S., Kruse, J., Lange, K., Lederbogen, F., & Petrak, F. (2013) · Diabetologie und Stoffwechsel · doi:10.1055/s-0033-1335889 · Cited by 24 · see citing works
Self-citationHuang, C., Chiu, H., Lee, M., & Wang, S.-Y. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.10.008 · Cited by 56 · see citing works
Depression and anxiety among parents of phenylketonuria children
Gündüz, M., Arslan, N., Ünal, Ö., Çakar, S., Kuyum, P., & Bülbül, S. F. (2015) · Neurosciences · doi:10.17712/nsj.2015.4.20150319 · Cited by 51 · see citing works
Streptozotocin-induced insulin deficiency leads to development of behavioral deficits in rats
Haider, S., Ahmed, S., Tabassum, S., Memon, Z., Ikram, M., & Haleem, D. J. (2012) · Acta Neurologica Belgica · doi:10.1007/s13760-012-0121-2 · Cited by 50 · see citing works
“debilitating acute and long-term complications resulting in ketoacidosis, blindness, renal failure, cardiovascular disease, strokes, amputations, and neuropathy [8, 9].”
BackgroundSex-related psychological effects on metabolic control in type 2 diabetes mellitus
Kacerovsky-Bielesz, G., Lienhardt, S., Hagenhofer, M., Kacerovsky, M., Forster, E., Roth, R., & Roden, M. (2009) · Diabetologia · doi:10.1007/s00125-009-1318-7 · Cited by 50 · see citing works
“Interestingly, the prevalence of anxiety is almost doubled in type 2 diabetic patients compared with healthy individuals [6].”
BackgroundHendrieckx, C., Ivory, N., Singh, H., Frier, B. M., & Speight, J. (2019) · Diabetic Medicine · doi:10.1111/dme.14067 · Cited by 46 · see citing works
Hermanns, N., Kulzer, B., Maier, B., Mahr, M., & Haak, T. (2011) · Patient Education and Counseling · doi:10.1016/j.pec.2011.05.017 · Cited by 47 · see citing works
“Elevated depressive and anxiety symptoms are also more common in insulin-treated patients than in non-insulin-treated patients with type 2 diabetes [7–9]; this state of affairs indicates that this patient group experiences a large emotional burden associated with diabetes and long-term as well as acute complications.”
BackgroundSelf-citationThabrew, H., Stasiak, K., Hetrick, S. E., Wong, S., Huss, J. H., & Merry, S. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012488 · Cited by 45 · see citing works
the Hertfordshire Cohort Study Group, Schlotz, W., Ambery, P., Syddall, H. E., Crozier, S., Sayer, A. A., Cooper, C. C., & Phillips, D. I. W. (2006) · Quality of Life Research · doi:10.1007/s11136-006-9129-5 · Cited by 43 · see citing works
“Approximately 30% of people with diabetes have depressive symptomatology and more than 10% have major depression [1–3].”
BackgroundAnxiety and risk of type 2 diabetes: Evidence from the Baltimore Epidemiologic Catchment Area Study
Edwards, L. E., & Mezuk, B. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.09.018 · Cited by 52 · see citing works
Timar, B., Mut-Vitcu, G., Timar, R. Z., Oancea, C. I., & Cîtu, C. (2016) · Clinical Interventions in Aging · doi:10.2147/cia.s104083 · Cited by 43 · see citing works
Mahmoudvand, H., Ziaali, N., Aghaei, I., Sheibani, V., Shojaee, S., Keshavarz, H., & Shabani, M. (2015) · Pathogens and Global Health · doi:10.1080/20477724.2015.1117742 · Cited by 40 · see citing works
Zeyfang, A., Bahrmann, A., & Wernecke, J. (2015) · Diabetologie und Stoffwechsel · doi:10.1055/s-0035-1553883 · Cited by 39 · see citing works
Zhu, X., Zhang, Y., Zhang, M., Chen, Y.-J., & Liu, Y. (2021) · Metabolic Brain Disease · doi:10.1007/s11011-021-00785-6 · Cited by 39 · see citing works
Relation Between Diabetes and Psychiatric Disorders
Akhaury, K., & Chaware, S. (2022) · Cureus · doi:10.7759/cureus.30733 · Cited by 34 · see citing works
“Compared to other diseases, people who have been diagnosed with schizophrenia are at higher risk to get type 2 diabetes [40].”
BackgroundWiltink, J., Michal, M., Wild, P. S., Schneider, A., König, J., Blettner, M., Münzel, T. F., Schulz, A., Weber, M. M., Fottner, C., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0105499 · Cited by 35 · see citing works
“[2–4]).”
Agomelatine and sertraline for the treatment of depression in type 2 diabetes mellitus
Karaiskos, D., Tzavellas, E., Ilias, Ι., Liappas, I., & Paparrigopoulos, T. J. (2013) · International Journal of Clinical Practice · doi:10.1111/ijcp.12112 · Cited by 36 · see citing works
Kostev, K., Dippel, F.-W., & Rathmann, W. (2014) · Primary Care Diabetes · doi:10.1016/j.pcd.2013.10.001 · Cited by 35 · see citing works
Chang, S. S. H., Abdin, E., Shafie, S., Sambasivam, R., Vaingankar, J. A., Ma, S., Chong, S. A., & Subramaniam, M. (2019) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2019.102106 · Cited by 33 · see citing works
Tasnim, R., Sujan, M. S. H., Islam, M. S., Ferdous, M. Z., Hasan, M. M., Koly, K. N., & Potenza, M. N. (2021) · Acta Psychologica · doi:10.1016/j.actpsy.2021.103426 · Cited by 33 · see citing works
Crisanti, A. (2012) · Pathogens and Global Health · doi:10.1179/136485912x13155264894283 · Cited by 31 · see citing works
Huang, C., Lin, C., Lee, M., Chang, K., & Chiu, H. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.12.011 · Cited by 31 · see citing works
“However, our study result differed from that of a previous study showing that younger or middle age is associated with a higher prevalence of depression disorders [7,10,17,18].”
BackgroundResultInfluentialManjarrez‐Gutiérrez, G., Herrera, R., León, M., & Hernández‐R, J. (2006) · Diabetes Care · doi:10.2337/diacare.29.01.06.dc05-1177 · Cited by 31 · see citing works
“In conclusion, these findings seem to have clinical relevance because brain serotonin is known to play an important role in the pathophysiology of various neuropsychiatric disorders that are commonly present in patients with type 1 diabetes like anxiety and depression (39).”
BackgroundAbraham, S., Shah, N. G., Roux, A. D., Hill-Briggs, F., Seeman, T., Szklo, M., Schreiner, P. J., & Golden, S. H. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.06.007 · Cited by 37 · see citing works
“, 2003), but there was no significant association in four studies (Fisher et al., 2008; Hall et al., 2009; Bouwman et al., 2010; Hermanns et al., 2005).”
BackgroundGeneralized anxiety disorder in type 2 diabetes mellitus: prevalence and clinical characteristics
Huang, C., Hsieh, H., Tu, H., Jiang, H., Wang, P., & Lin, C. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2019-0605 · Cited by 30 · see citing works
Tu, H., Lin, C., Hsieh, H., Jiang, H., Wang, P., & Huang, C. (2016) · Psychiatric Quarterly · doi:10.1007/s11126-016-9436-0 · Cited by 28 · see citing works
Vulnerability to stress, anxiety and depressive symptoms and metabolic control in Type 2 diabetes
Góis, C., Dias, V. V., Raposo, J. F., do Carmo, I., & Barbosa, A. (2012) · BMC Research Notes · doi:10.1186/1756-0500-5-271 · Cited by 27 · see citing works
“Nevertheless, in recent studies, T2DM patients did not present an association regarding their anxiety disorder or symptoms with HbA1c [18,21].”
ResultThe epidemiology of depression in diabetes
Winkley, K. (2008) · European Diabetes Nursing · doi:10.1002/edn.117 · Cited by 28 · see citing works
“In individuals with diabetes, the following additional risk factors for depression have been found to be important: occurrence of late or acute complications, persistently poor glycaemic control and insulin therapy in type 2 diabetes [35, 36] (Table 1.”
BackgroundKruse, J., Petrak, F., Herpertz, S., Albus, C., Lange, K., & Kulzer, B. (2006) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2006.52.3.289 · Cited by 26 · see citing works
Self-citationPrinz, N., Ebner, S., Grünerbel, A., Henkelüdecke, U., Hermanns, N., Hummel, M., Schäfer, C., Wagner, C., Weiland, J., Welp, R., et al. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.08.077 · Cited by 26 · see citing works
Self-citationPredictive Factors of Anxiety and Depression in Patients with Type 2 Diabetes Mellitus
Albai, O., Timar, B., Braha, A., & Timar, R. Z. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13103006 · Cited by 32 · see citing works
“Alcohol misuse is the most prevalent addiction issue among patients with DM, with a prevalence rate of 50–60% [56–58].”
BackgroundA Practical Approach to Mental Health for the Diabetes Educator
Gonzalvo, J. D., Hamm, J. A., Eaves, S. M., Muñoz, C. E., de Groot, M., Hill‐Briggs, F., Cypress, M., & Streisand, R. M. (2019) · AADE in Practice · doi:10.1177/2325160319826929 · Cited by 25 · see citing works
“26 Similarly, youth with diabetes are at risk for elevated levels of anxiety.(27) Rates of anxiety symptoms are 20% with higher rates observed in studies that have measured anxiety symptoms using symptoms checklists or questionnaires (e.”
BackgroundMcDade‐Montez, E., & Watson, D. (2011) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9298-5 · Cited by 25 · see citing works
“In a review of 18 studies, Grigsby, Anderson, Freedland, Clouse, and Lustman [7] found similarly elevated rates of anxiety disorders and symptoms in Type 1 and Type 2 diabetes patients, although other research has found elevated anxiety symptoms among Type 2 versus Type 1 patients [8].”
BackgroundPark, S., Lee, H.-Y., Lee, D. W., Hahn, S., Park, S., Kim, Y. J., Choi, J. S., Lee, H.-S., Lee, S. I., Na, K., et al. (2017) · Psychiatry Investigation · doi:10.4306/pi.2017.14.3.306 · Cited by 24 · see citing works
Key concepts in screening for depression in people with diabetes
Holt, R. I. G., & Feltz-Cornelis, C. M. V. D. (2012) · Journal of Affective Disorders · doi:10.1016/s0165-0327(12)70011-3 · Cited by 23 · see citing works
Kulkarni, V., Chinnakali, P., Kanchan, T., Rao, A., Shenoy, M., & Papanna, M. K. (2014) · Europe PMC (PubMed Central) · Cited by 22 · see citing works
Reimer, A., SCHMITT, A. J., Ehrmann, D., Kulzer, B., & Hermanns, N. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181218 · Cited by 22 · see citing works
Self-citationHuang, C., Hsieh, H., Tu, H., Jiang, H., Wang, P., & Lin, C. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.09.044 · Cited by 22 · see citing works
“However, the prevalence of MDD in the patients with T2DM in the present study was lower than that reported by studies conducted in Western countries (Banerjea et al., 2009; Fisher et al., 2008; Hermanns et al., 2005).”
ResultInfluentialManjarrez‐Gutiérrez, G., Herrera, R., Mejenes, S., Godinez-Lopez, T., & Hernández‐R, J. (2009) · The World Journal of Biological Psychiatry · doi:10.1080/15622970902717032 · Cited by 21 · see citing works
“…deterioration that changes familiar dynamics and has been considered a risk factor for poor metabolic control because physical activity is decreased, favouring obesity and potentially causing additional chronic complications (Wilkinson et al. 1988; Hermanns et al. 2005; Lawrence et al. 2006).”
BackgroundAbdin, E., Chong, S., Vaingankar, J. A., Shafie, S., Seah, D., Chan, C., Ma, S., James, L., Heng, D., & Subramaniam, M. (2020) · Singapore Medical Journal · doi:10.11622/smedj.2020124 · Cited by 22 · see citing works
“Several studies have also reported that the prevalence of anxiety disorders among patients with DM is considerably higher than among the general population.((36,37)) Increase in the prevalence of comorbid anxiety among people with DM could be explained by several factors.”
BackgroundThe Relationship Between Adult Neuropsychological Profiles and Diabetic Patients' Glycemic Control
Zihl, J., Schaaf, L., & Zillmer, E. A. (2010) · Applied Neuropsychology · doi:10.1080/09084280903526133 · Cited by 20 · see citing works
“Unsuccessful coping may not only adversely affect cognitive efficiency (e.g., Hislop et al., 2008) but may also represent a risk factor for developing affective symptoms (Hermanns et al., 2005) and for increased sickness absence (Kivimäki et al., 2007).”
BackgroundHasan, S. S., Clavarino, A. M., Mamun, A. A., & Kairuz, T. E. (2015) · Public Health · doi:10.1016/j.puhe.2015.07.022 · Cited by 19 · see citing works
Human Emotions on the Onset of Cardiovascular and Small Vessel Related Diseases
Vlachakis, C., Dragoumani, K., Raftopoulou, S., Mantaiou, M., Papageorgiou, L., Tsaniras, S. C., Megalooikonomou, V., & Vlachakis, D. (2018) · In Vivo · doi:10.21873/invivo.11320 · Cited by 20 · see citing works
Thabrew, H., Stasiak, K., Hetrick, S. E., Wong, S., Huss, J. H., & Merry, S. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012489 · Cited by 18 · see citing works
Iversen, M. M., Nefs, G., Tell, G. S., Espehaug, B., Midthjell, K., Graue, M., & Pouwer, F. (2016) · PLOS ONE · doi:10.1371/journal.pone.0160861 · Cited by 21 · see citing works
Increased depression symptom score in newly diagnosed type 2 diabetes patients
Rathmann, W., Kuß, O., Anderson, D., Busch, S., Hahn, M., Engelhard, J., Zou, M., & Kostev, K. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.12.091 · Cited by 16 · see citing works
Bahrmann, A., Bahrmann, P., Kubiak, T., Kopf, D., Oster, P., Sieber, C. C., & Daniel, W. G. (2012) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-011-0269-z · Cited by 16 · see citing works
Self-citationEffects of Physical Activity on Depression in Adults with Diabetes
Kim, D.-J. (2018) · Osong Public Health and Research Perspectives · doi:10.24171/j.phrp.2018.9.4.02 · Cited by 16 · see citing works
“Results of studies conducted in the early and mid-2000s, showed that unmarried individuals with diabetes were more depressed than married individuals with diabetes [21,22].”
ResultWhitworth, S. R., Bruce, D. G., STARKSTEIN, S. E., Davis, T. M. E., Skinner, T. C., Davis, W. A., & Bucks, R. S. (2020) · Diabetic Medicine · doi:10.1111/dme.14344 · Cited by 13 · see citing works
A szorongás és a diabetes közti kapcsolat
Hargittay, C., Gonda, X., Márkus, B., Sipkovits, Z., Vörös, K., Kalabay, L., Rihmer, Z., & Torzsa, P. (2021) · Orvosi Hetilap · doi:10.1556/650.2021.32169 · Cited by 14 · see citing works
“[15] Hermanns N, Kulzer B, Krichbaum M, et al.”
BackgroundPsychological Burden of Diabetes and What It Means to People with Diabetes
Barnard, K. D., Lloyd, C. E., & Holt, R. I. G. (2011) · Springer eBooks · doi:10.1007/978-0-85729-573-6_1 · Cited by 14 · see citing works
Chew, B., Vos, R. C., Ghazali, S. S., Shamsuddin, N. H., Fernandez, A., Mukhtar, F., Ismail, M., Ahad, A. M., Sundram, N. N., Ali, S. Z. M., et al. (2017) · BMC Endocrine Disorders · doi:10.1186/s12902-017-0172-8 · Cited by 14 · see citing works
“Studies in the United States (US) [8] and Germany [9] showed T2DM patients displaying one to twofold higher rates of affective disorders such as major depression, general anxiety, panic disorder and dysthymia compared to healthy adults, with the prevalence of depressive symptoms and distress 60–73% higher than the oth…”
BackgroundThe Epidemiology of Depression and Diabetes
Lloyd, C. E., Hermanns, N., Nouwen, A., Pouwer, F., Underwood, L., & Winkley, K. (2010) · Depression and Diabetes · doi:10.1002/9780470667309.ch1 · Cited by 23 · see citing works
Self-citationChernyak, N., Petrak, F., Plack, K., Hautzinger, M., Müller, M. J., Giani, G., & Icks, A. (2009) · BMC Geriatrics · doi:10.1186/1471-2318-9-25 · Cited by 13 · see citing works
“This applies in particular to patients with diabetes, since depression has been shown to be more prevalent among these patients as compared to those without diabetes [ 3- 5 ]. Major depression and elevated depression symptoms were present, respectively, in 11 and 31% of individuals with diabetes according to a meta-an…”
ResultYücel, Ş. Ç., Güler, E. K., & Ak, İ. (2014) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-014-0206-y · Cited by 14 · see citing works
Mast, R., Rauh, S. P., Groeneveld, L., Koopman, A. D. M., Beulens, J. W. J., Jansen, A. P. D., Bremmer, M. A., van der Heijden, A. A. W. A., Elders, P. J. M., Dekker, J. M., et al. (2017) · BioMed Research International · doi:10.1155/2017/5134602 · Cited by 13 · see citing works
“This is in accordance with other literatures on the association between depression and T2DM [27] in that it may reflect disease progression.”
Problemspezifische Patientenschulung
Hermanns, N., Kulzer, B., & Krichbaum, M. (2008) · Der Diabetologe · doi:10.1007/s11428-008-0243-6 · Cited by 13 · see citing works
Self-citationDalsgaard, E., Graversen, S. B., Bjerg, L., Sandbæk, A., & Laurberg, T. (2024) · Diabetic Medicine · doi:10.1111/dme.15463 · Cited by 12 · see citing works
Denche-Zamorano, Á., Pérez-Gómez, J., Barrios-Fernández, S., Oliveira, R., Adsuar, J., & Brito, J. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20042857 · Cited by 11 · see citing works
Assessment of depression and death anxiety level in diabetic patients in Eskisehir, Turkey
Doğan, R., Arslantaş, D., & Ünsal, A. (2015) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-014-0254-3 · Cited by 12 · see citing works
“Although there are some previous studies reporting a decreasing level of anxiety with increasing educational level [36, 37], several researchers found no relationship [38].”
ResultGlycemic Outcome Not Predicted by Baseline Psychological Measures in a Diabetes Management Program
Graco, M., Hutchinson, A. F., Barker, A. L., Lawlor, V., Wong, R., & Fourlanos, S. (2012) · Population Health Management · doi:10.1089/pop.2011.0043 · Cited by 12 · see citing works
“,7–11 There are several potential explanations for these findings.”
A Study on Depression among Patient with Type 2 DiabetesMellitus in North-Eastcoast Malaysia
Mohamed, R., Kadir, A. A., & Yaacob, L. H. (2012) · International journal of collaborative research on internal medicine & public health · Cited by 12 · see citing works
Tu, H., Hsieh, H., Liu, T., Jiang, H., Wang, P., & Huang, C. (2016) · Psychosomatics · doi:10.1016/j.psym.2016.11.007 · Cited by 11 · see citing works
Pieper, L., Dirmaier, J., Klotsche, J., Thurau, C., Pittrow, D., Lehnert, H., März, W., Koch, U., & Wïttchen, H. (2010) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1181-1 · Cited by 11 · see citing works
“Als diabetesabhängige Faktoren wurden Folgekomplikationen, Insulintherapie, Hypoglykämien und ein hoher HbA1c bestätigt [14, 19].”
BackgroundPredictors of early discontinuation of basal insulin therapy in type 2 diabetes in primary care
Kostev, K., Dippel, F. W., & Rathmann, W. (2015) · Primary care diabetes · doi:10.1016/j.pcd.2015.08.001 · Cited by 10 · see citing works
The Association between Preoperative Parental Anxiety and Emergence Agitation in Preschoolers
Erkılıç, E., Kesimci, E., Döğer, C., Gümüş, T., & Kanbak, O. (2017) · Open Journal of Epidemiology · doi:10.4236/ojepi.2017.71003 · Cited by 10 · see citing works
“Although no cut-off indicating clinically significant levels of anxiety is established in the technical or administrative materials for the STAI, cut-offs of 40 and 45 were used in prior studies [9] [10] [11] [12].”
MethodHermanns, N., Ehrmann, D., Finke-Gröne, K., Roos, T., Freckmann, G., & Kulzer, B. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968221148756 · Cited by 9 · see citing works
“10-16 Digital applications such as insulin titration apps may have the potential to overcome these barriers.”
Self-citationSerotonin - Neurotransmitter and Hormone of Brain, Bowels and Blood
Fatima-Shad, K. (2023) · IntechOpen eBooks · doi:10.5772/intechopen.1000435 · Cited by 9 · see citing works
Hargittay, C., Eőry, A., Márkus, B., Mohos, A., Ferenci, T., Vörös, K., Rihmer, Z., Gonda, X., & Torzsa, P. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.944047 · Cited by 9 · see citing works
Factors associated with anxiety in type 2 diabetes mellitus patients in Pakistan
Nawaz, M. S., Shah, K. U., Rashid, H., Mahmood, S., Bukhsh, A., Rehman, I. U., Ali, S., & Khan, T. M. (2017) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-017-0591-0 · Cited by 9 · see citing works
- Authors
- Hermanns, N., Kulzer, B., Krichbaum, M., Kubiak, T., & Haak, T.
- Affiliations
- German Diabetes Center Mergentheim (DE)
- University of Bamberg (DE)
- Corresponding author
- Hermanns, N.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2005-02-16
- Volume
- 22
- Issue
- 3
- Pages
- 293-300
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2103920393
- Cited by
- 170
- References
- 39
- Citations by year
- 2026: 4 · 2024: 7 · 2023: 5 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 8 · 2018: 8 · 2017: 13 · 2016: 11 · 2015: 13 · 2014: 6 · 2013: 10 · 2012: 17
- FWCI
- 3.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- diabetes mellitus, mood disorders, anxiety disorders, depression, comorbidities, prevalence, risk factors, type 1 diabetes, type 2 diabetes, insulin therapy, hypoglycemia, glycemic control, subclinical symptoms
- MeSH terms
- Adolescent, Adult, Age Factors, Anxiety, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Male, Middle Aged, Risk Factors, Sex Factors, Comorbidity, Prevalence, Logistic Models, Mood Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
