Article Figures & Data
Figures
- Figure 1
Negative affect (CES-D) and prior MDD mediation model.
CES-D = Center for Epidemiological Studies-Depression Scale; MDD = major depressive disorder; NLE = Negative Life Events Scale; OR = odds ratio.
a P <.01.
b P <.001.
- Figure 2
Negative affect (CES-D) and negative life events mediation model.
CES-D = Center for Epidemiological Studies-Depression Scale; MDD = major depressive disorder; NLE = Negative Life Events Scale; OR = odds ratio.
a P <.001.
b P <.01.
Tables
Characteristic All Cases Age, mean (SD), y 58 ± 9.88 Female, n (%) 254 (56.4) White race, n (%) 158 (35.1) Income, mean (SD), $ (thousands) 52.7 ± 36.0 Diet adherence last week, mean (SD), d 4.2 ± 1.54 Exercise adherence last week, mean (SD), d 3.2 ± 2.30 Hemoglobin A1c, mean (SD), % 7.3 ± 1.46 Body mass index, mean (SD), kg/m2 32.5±7.62 Comorbidities, mean (SD), n 3.7 ± 2.42 Diabetes complications,a mean (SD), n 0.8 ± 1.22 Prior major depressive disorder, n (%) 94 (20.9) Negative life events in past 12 mo, mean (SD), n 3.5 ± 3.05 Negative affect at baseline, mean (SD), n 9.9 ± 9.97 -
↵a Affected the nerves in your arms, legs, toes, or feet, that you have neuretinopathy; led to cataracts; led to skin problems; led to infections; had an amputation.
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Characteristic General Patient Characteristics
OR (95% CI)Behavioral Variables
OR (95% CI)Biologic Variables
OR (95% CI)Psychosocial Variables
OR (95% CI)Combined Model
OR (95% CI)Age 0.95a (0.92–0.99) – – – 0.96 (0.92–1.01) Female 1.64 (0.77–3.46) – – – 1.29 (0.50–3.30) White race 1.16 (0.55–2.45) – – – 0.96 (0.37–2.46) Income 0.99a (0.98–1.01) – – – 1.00 (0.98–1.01) Diet adherence – 0.87 (0.70–1.08) – – – Exercise adherence – 0.95 (0.80–1.08) – – – Hemoglobin A1c – – 1.22a(1.01–1.49) – 1.12 (0.87–1.43) BMI – – 1.04a (1.01–1.09) – 1.01 (0.95–1.08) No. of comorbidities – – 1.10 (0.97–1.25) – – No. of diabetes complications – – 0.87 (0.65–1.18) – – Prior MDD – – – 4.15c (1.97–8.73) 4.19b (1.79–9.79) No. of negative life events – – – 1.11a (1.01–1.24) 1.10 (0.98–1.24) Negative affect at baseline – – – 1.08c (1.05–1.11) 1.09c (1.05–1.13) - Table 3
Adjusted Odds of MDD at 9 and/or 18 Months, Stratified by Moderate (−NA) and High (+NA) Negative Affect
All Cases (N=338)
OR (95% CI)−NA (n=121) a
OR (95% CI)+NA (n=61) b
OR (95% CI)Age 0.96 (0.92–1.01) 0.97 (0.92–1.02) 0.95 (0.88–1.03) Female 1.29 (0.50–3.30) 1.32 (0.43–4.06) 2.88 (0.49–17.07) White race 0.96 (0.37–2.46) 0.62 (0.20–1.92) 1.37 (0.27–7.12) Income 1.00 (0.98–1.01) 1.00 (0.99–1.02) 1.01 (0.99–1.03) Hemoglobin A1c 1.12 (0.87–1.43) 1.36c(1.01–1.85) 1.63c (1.06–2.53) BMI 1.01 (0.95–1.08) 1.09c(1.01–1.18) 1.08 (0.97–1.21) Prior MDD 4.19d (1.79–9.79) 3.10c (1.15–8.41) 2.69 (0.69–10.52) No. of negative life events 1.10 (0.98–1.24) 1.14c(1.01–1.31) 1.21c (1.01–1.45) Negative affect at baseline 1.09e (1.05–1.13) – – -
BMI=body mass index; CI=confidence interval; hemoglobin A1c=glycated hemoglobin; MDD=major depressive disorder; OR = odds ratio.
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↵a −NA, group of patients with CES-D cutoff scores of 310 and no MDD at baseline.
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↵b +NA, group of patients with CES-D cutoff scores of 316 and no MDD at baseline.
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↵c P <.05.
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↵d P <.01.
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↵e P < .001.
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The Article in Brief
Patients With Type 2 Diabetes at Risk for Major Depressive Disorder Over Time
Diana M. Naranjo , and colleagues
Background Depression is common among patients with type 2 diabetes. This study set out to identify characteristics that predict the onset of major depressive disorder (MDD) among primary care patients with diabetes.
What This Study Found Among 338 adult patients with type 2 diabetes, researchers found prior MDD and negative affect were the primary predictors of subsequent MDD. When stratified by negative affect, negative life events, elevated body mass index, and poor control of glycated hemoglobin also predicted MDD.
Implications
- Negative life events and patients� disease-related concerns are important when understanding what predicts MDD. The authors conclude that these variables combine to yield the negative emotional symptoms that predict MDD over time.
- When patients have moderate levels of increased depressive symptoms, it may be helpful to inquire about other life stressors and chronic disease management. Devoting attention to these factors may have a positive impact on patients' emotional status as well as their disease management.
