Contributors to Depression in Latino and European-American Patients With Type 2 Diabetes
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OBJECTIVE—To determine the independent and cumulative contributions of diabetes and other life stresses on depression and anxiety in Latino and European-American (EA) patients with diabetes. RESEARCH DESIGN AND METHODS—A total of 75 Latino and 113 EA patients with type 2 diabetes, recruited from managed care settings, were assessed regarding three groups of potential stresses: demographics (age, sex, and education), disease status (functional impact, time since diagnosis, comorbidities, HbA1c, and BMI), and family stress (financial stress, spouse conflict resolution, and family closeness). Dependent variables were depression (Center for Epidemiological Studies–Depression scale [CES-D]) and anxiety (Symptom Checklist [SCL-90]). Multiple regression equations assessed the independent contribution of each predictor on depression and anxiety. RESULTS—For both ethnic groups, education, functional impact, and financial stress significantly and independently predicted depression; poor spouse conflict resolution was a fourth significant predictor for EA patients only. The equations accounted for a high percentage of variance (43– 55%). Excluding education, the same variables predicted anxiety for both ethnic groups. The disease status and family stress variable groups significantly predicted outcomes independently. The relationships among these variables and depression and anxiety generally occurred for all patients, not only for those classified as likely depressed. CONCLUSIONS—The findings suggest the utility of considering many life stresses, not just diabetes alone, that combine to affect depression and anxiety. We suggest that these effects are experienced cumulatively as general psychological distress for all patients with diabetes, not just those classified as likely depressed. Taken together, the findings emphasize a life-centered, patient-focused approach to the treatment of depression, rather than an exclusive disease-related perspective.
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Studies of the prevalence of co-occurring anxiety and affective disorders have yielded mixed results.
“Studies of the prevalence of co-occurring anxiety and affective disorders have also yielded mixed results [9–11]”
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 [10]
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- Authors
- Fisher, L., Chesla, C. A., Mullan, J. T., Skaff, M. M., & Kanter, R. A.
- Affiliations
- University of California, San Francisco (US)
- Kaiser Permanente (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2001-10-01
- Volume
- 24
- Issue
- 10
- Pages
- 1751-1757
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1971742946
- Cited by
- 170
- References
- 54
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 2 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 7 · 2017: 11 · 2016: 5 · 2015: 5 · 2014: 3 · 2013: 8 · 2012: 14
- Type
- paratext
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- National Institutes of Health (5r01dk049816-03)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK49816, DK53203)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- type 2 diabetes, depression, anxiety, Hispanic patients, European American patients, life events, family stress, financial stress, psychological distress, ethnic differences
- MeSH terms
- Adult, Central America, Conflict, Psychological, Depression, Diabetes Mellitus, Type 2, Ethnicity, Europe, Family Relations, Female, Glycated Hemoglobin, Hispanic or Latino, Humans, Income, Male, Managed Care Programs, Mexico, Middle Aged, Regression Analysis, Socioeconomic Factors, Stress, Psychological, United States
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