201
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Lys R, Belanger E, Phillips SP. Improved mood despite worsening physical health in older adults: Findings from the International Mobility in Aging Study (IMIAS). PLoS One 2019; 14:e0214988. [PMID: 30958861 PMCID: PMC6453471 DOI: 10.1371/journal.pone.0214988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/25/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives Older adults experience increasing physical illness with age, but paradoxically, they frequently describe improvements in mood and self-rated health. The role of declining physical health as a risk for depression in elderly men and women remains unclear. We assessed whether declining physical health predicted changes in depression over time among seniors using data from the International Mobility in Aging Study (IMIAS). Methods IMIAS is a longitudinal population-based study of older adults in Canada, Colombia, and Brazil. We assessed change in depression by comparing Center for Epidemiology–Depression (CES-D) scores for 1161 men and women between 2012 and 2016, and used multiple regression to identify whether changes in chronic health conditions, grip strength and self-rated health predicted change in depression over time. Results Despite worsening physical health measured as chronic health conditions and grip strength, mean CES-D scores decreased from 8.15 (95% CI 7.70–8.60) in 2012 to 7.15 (95% CI 6.75 to 7.56) in 2016. Counterintuitively, women reported increased self-rated health despite having declining physical health, p = 0.004. Decreases in depressive symptoms were aligned with higher CES-D in 2012 and with increases in self-rated health among women and overall, and with high CES-D 2012 and increases in chronic health conditions in men, ps < 0.05. Conclusions Mental health appears to be a fundamentally different construct than physical health in older adults, allowing seniors to experience improved mood despite declining physical health. Clinicians should not consider depression in elderly populations as an inevitability of aging.
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Affiliation(s)
- Rebecca Lys
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Emmanuelle Belanger
- Center for Gerontology and Healthcare Research, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Susan P Phillips
- Family Medicine and Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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202
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Melo HM, Santos LE, Ferreira ST. Diet-Derived Fatty Acids, Brain Inflammation, and Mental Health. Front Neurosci 2019; 13:265. [PMID: 30983955 PMCID: PMC6448040 DOI: 10.3389/fnins.2019.00265] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/06/2019] [Indexed: 12/21/2022] Open
Abstract
Western societies experienced drastic changes in eating habits during the past century. The modern nutritional profile, typically rich in saturated fats and refined sugars, is recognized as a major contributing factor, along with reduced physical activity, to the current epidemics of metabolic disorders, notably obesity and diabetes. Alongside these conditions, recent years have witnessed a gradual and significant increase in prevalence of brain diseases, particularly mood disorders. While substantial clinical/epidemiological evidence supports a correlation between metabolic and neuropsychiatric disorders, the mechanisms of pathogenesis in the latter are often multifactorial and causal links have been hard to establish. Neuroinflammation stands out as a hallmark feature of brain disorders that may be linked to peripheral metabolic dyshomeostasis caused by an unhealthy diet. Dietary fatty acids are of particular interest, as they may play a dual role, both as a component of high-calorie obesogenic diets and as signaling molecules involved in inflammatory responses. Here, we review current literature connecting diet-related nutritional imbalance and neuropsychiatric disorders, focusing on the role of dietary fatty acids as signaling molecules directly relevant to inflammatory processes and to neuronal function.
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Affiliation(s)
- Helen M. Melo
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luís Eduardo Santos
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sergio T. Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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203
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Carruth L, Mendenhall E. "Wasting away": Diabetes, food insecurity, and medical insecurity in the Somali Region of Ethiopia. Soc Sci Med 2019; 228:155-163. [PMID: 30913529 DOI: 10.1016/j.socscimed.2019.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 01/17/2023]
Abstract
Most research on diabetes has taken place in cities or in high-income countries, even though most diabetes deaths occur in low and middle-income countries, and diabetes disproportionately affects the poor. This research, by contrast, investigates rising concerns about diabetes among Somalis in eastern Ethiopia--in communities where obesity is rare and people face chronic food insecurity, forced displacement, recurrent humanitarian crises, and lack of access to medical care. Findings presented in this article build on ethnographic research with Somalis in eastern Ethiopia since 2007, and include anthropometric and demographic data collection with Somali diabetes patients and select adult siblings of these patients (n = 108) plus in-depth ethnographic interviews with a subset of the diabetes patients, their siblings, and medical providers serving Somali communities (n = 29) in July-August 2018. Most Somali patients we spoke with shared symptoms of progressive weight loss, weakness, and loss of teeth--or what people called "wasting away"--even when complying with prescribed pharmaceutical regimens and/or insulin. Diabetes and "wasting away" were characterized by Somalis as humoral pathologies; but rather than a consequence of obesity or pathological weight gain, these were perceived to be a consequence of stress, trauma, anger, displacement, loss of healthy fatness, and lack of access to fresh and healthy food over their lifetimes. Somalis' simultaneous experiences of progressive nutritional wasting and adult-onset diabetes echo how "tropical diabetes" was defined and experienced for thousands of years prior to the development of effective early diagnostics and biomedical treatments. This analysis therefore suggests heterogeneity and overlaps within and between categories of "type 1" and "type 2 diabetes" in populations with differential exposures to stress, crisis, and poverty. Exposures to food insecurity and medical insecurity, in particular, are pathogenic, and shape diabetes patients' clinical presentations and prognoses, as well as local etiologies and patterns of disease.
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Affiliation(s)
- Lauren Carruth
- School of International Service, American University, 4400 Massachusetts Ave NW, Washington DC, 20016, USA.
| | - Emily Mendenhall
- School of Foreign Service, Georgetown University, 513 Intercultural Center, 37th and O Street, NW, Washington DC, 20057, USA.
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204
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Li H, Ji M, Scott P, Dunbar-Jacob JM. The Effect of Symptom Clusters on Quality of Life Among Patients With Type 2 Diabetes. DIABETES EDUCATOR 2019; 45:287-294. [DOI: 10.1177/0145721719837902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose The purpose of this study was to examine the collective effect of a symptom cluster (depression, anxiety, fatigue, and impaired sleep quality) at baseline on the quality of life (QOL) of patients with type 2 diabetes (T2DM) over time. Methods This was a secondary data analysis of 302 patients with T2DM who presented with both hypertension and hyperlipidemia. All of the participants were enrolled in a randomized controlled intervention study testing strategies to improve medication adherence. The psychological symptoms and QOL were assessed at baseline, 6 months, and 12 months. Cluster analysis was used to identify subgroups of patients based on the severity of symptoms at baseline. Results Hierarchical cluster analysis identified 4 patient subgroups: all low severity, mild, moderate, and all high severity. There were significant differences in patients’ QOL overall among the 4 subgroups. Compared with the all-low-severity subgroup, subgroups with higher severity of the 4 symptoms had poorer QOL across all 3 time points. QOL was most impacted by trait anxiety across the 3 time points. Conclusion QOL was significantly impacted by psychological symptom clusters among patients with T2DM. Healthcare providers should not neglect psychological symptoms that patients experience. It is important to assess and manage these symptoms to improve QOL among patients with diabetes.
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Affiliation(s)
- Hongjin Li
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Ms Li)
| | - Meihua Ji
- School of Nursing, Capital Medical University, Beijing, China (Dr Ji)
| | - Paul Scott
- Department of Health & Community Systems, Center for Research & Evaluation, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Dr Scott)
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205
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Jaworski M, Panczyk M, Śliwczyński A, Brzozowska M, Janaszek K, Małkowski P, Gotlib J. Severe Depressive Episode with Psychotic Symptoms and Type 2 Diabetes: A 2010-2017 Longitudinal Study. Med Sci Monit 2019; 25:1760-1768. [PMID: 30846676 PMCID: PMC6419531 DOI: 10.12659/msm.913356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There have been few studies published on the prevalence of severe depressive episode in people with type 2 diabetes (T2DM) or its role in adherence to dietary recommendations. We examined the Polish National Health Fund (NFZ) database estimates of all medical visits from 2010 to 2017 to determine the trend and the epidemiology of severe depressive episode in T2DM. MATERIAL AND METHODS The NFZ database was used. We defined the T2DM group diagnosed with both T2DM and severe depressive episode according to the ICD-10 codes. The annual prevalence of severe depressive episode was estimated according to the T2DM diagnosis status, and the age groups were stratified into 8 groups. RESULTS Relative risk for depression (regardless of severity of symptoms) in T2DM is 1.347 [95%CI: 1.342-1.353]. The frequency trend of severe depressive episode with or without psychotic symptoms remains relatively stable. In the case of mild and moderate depressive episode, a downward trend was noted, but they are still the most frequent mood disorders diagnosed. Patients with T2DM aged 20 to 40, for whom the peak of coexistence of these illnesses was noted, are the group particularly vulnerable to depression. Depression also remains on a relatively high but stable level for patients over 60 years of age. CONCLUSIONS The coexistence of depressive episodes in T2DM is a key challenge for medicine and public health. Measures aimed at early identification of patients with T2DM prone to depression need to be taken. Creating multidisciplinary care teams in diabetes management is also necessary.
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Affiliation(s)
- Mariusz Jaworski
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Śliwczyński
- Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Melania Brzozowska
- Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Katarzyna Janaszek
- Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Piotr Małkowski
- Department of Surgical and Transplant Nursing and Extracorporeal Treatment, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Gotlib
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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206
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The effect of chronic physical illnesses on psychiatric hospital admission in patients with recurrent major depression. Psychiatry Res 2019; 272:602-608. [PMID: 30616130 DOI: 10.1016/j.psychres.2018.12.178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 11/26/2018] [Accepted: 12/31/2018] [Indexed: 12/19/2022]
Abstract
People with major depressive disorder (MDD) have an increased burden of chronic physical illnesses (CPI). However, information about the effect of CPIs on recurrent MDD treatment outcome is limited. The objective of this study was to explore whether the number of CPIs in patients with recurrent MDD was associated with higher rate of psychiatric admissions. Data were collected for a consecutive sample of 190 patients diagnosed with recurrent MDD. The key outcome was the number of psychiatric admissions following psychiatric diagnosis. The independent variable was the number of CPIs. The effects of different clinical, sociodemographic, and lifestyle confounding factors were controlled using robust regression. The patients with CPI had significantly more psychiatric admissions than the patients without CPI, and the number of CPIs was significantly associated with the number of psychiatric admissions. The results of our study largely confirmed that more than two CPIs in patients diagnosed with recurrent MDD are associated with higher rates of psychiatric admission, independent of psychiatric comorbidities and other clinical and sociodemographic factors. These findings indicate that to improve treatment outcome and to reduce recurrence, it is crucial to enhance early recognition and treatment of physical comorbidity.
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207
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Mori K, Mori T, Nagata T, Nagata M, Iwasaki M, Sakai H, Kimura K, Shinzato N. Factors of occurrence and improvement methods of presenteeism attributed to diabetes: A systematic review. J Occup Health 2019; 61:36-53. [PMID: 30698334 PMCID: PMC6499359 DOI: 10.1002/1348-9585.12034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/11/2018] [Indexed: 01/22/2023] Open
Abstract
Objective A systematic review was performed to study factors of occurrence and improvement methods of presenteeism attributed to diabetes. Methods We set 2 clinical questions; (a) how comorbidities and complications of diabetes induce presenteeism and (b) what interventions or conditions effectively improve presenteeism. Then, we conducted a comprehensive search with MEDLINE/PubMed and Scopus databases and extracted those that met the clinical questions. Results Eighteen papers studied occurrence of presenteeism by comorbidities and complications of diabetes. Most studies were cross‐sectional and had a low quality of evidence. However, the associations of hypoglycemia, diabetic neuropathy, and mood disorders with presenteeism were relatively well studied. The papers that discussed effective interventions or conditions for improving presenteeism were very limited. Conclusions Our review suggests that presenteeism attributed to diabetes is mainly caused by hypoglycemia, diabetic neuropathy, and mood disorders. There are very limited evidences, but available information suggests that improving glycemic control, adjusting treatment regimen by evaluating the impact on work, providing psychological support, and developing suitable work accommodations may effectively reduce presenteeism.
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Affiliation(s)
- Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takahiro Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masako Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mahoko Iwasaki
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroki Sakai
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koki Kimura
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Natsumi Shinzato
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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208
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Murillo LA, Grekoff GA, Sheffield JC. Assessing the effect of patient to provider language discordance on depression screening utilizing the Patient Health Questionnaire: an epidemiology study. Fam Pract 2019; 36:27-31. [PMID: 30299462 DOI: 10.1093/fampra/cmy097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As depression screening becomes a standard in primary care, the question remains of how effective and equitable screening can be implemented to avoid cultural and language-related disparities. METHODS In this retrospective cohort study, rates of depression screening were compared for 3626 adult patients at a family medicine residency-based health centre in Pennsylvania, USA. The PHQ-2/PHQ-9 modality was verbally administered by nursing staff at the time of patient intake as part of a universal screening initiative. Chi-square analysis was used to determine the univariate associations of performed depression screening with variables of language, ethnicity, gender and number of office visits. A binary logistic regression was then performed to measure whether univariate associations remain significant after correction for other variables. RESULTS Chi-square analysis revealed significant differences in screening based on univariate associations of language, gender and number of office visits. No significant difference was found for age or ethnicity. Binary logistic regression revealed the following odds ratio of being screened for depression for each variable: Spanish language (OR = 0.694, CI = 0.559 to 0.862), female gender (OR = 1.155, CI = 1.005 to 1.328) and office visit frequency of three or more office visits per year (OR = 2.103, CI = 1.835 to 2.410). CONCLUSIONS Spanish-speaking adults were significantly less likely to be screened for depression than their English-speaking counterparts. Women were more likely to be screened than men, and the odds of screening increased with more frequent exposure to the office. Future studies should be directed at validating these findings in multiple clinical settings.
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Affiliation(s)
- Luis A Murillo
- Reading Hospital Department of Family Medicine Residency, Tower Health, West Reading, USA
| | - Georgi Alex Grekoff
- Reading Hospital Department of Family Medicine Residency, Tower Health, West Reading, USA
| | - John C Sheffield
- Reading Hospital Department of Family Medicine Residency, Tower Health, West Reading, USA
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209
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Yasui-Furukori N, Murakami H, Otaka H, Nakayama H, Murabayashi M, Mizushiri S, Matsumura K, Tanabe J, Matsuhashi Y, Yanagimachi M, Nakamura K, Daimon M, Sugawara N. Coping behaviors and depressive status in individuals with type 2 diabetes mellitus. Ann Gen Psychiatry 2019; 18:11. [PMID: 31346344 PMCID: PMC6636138 DOI: 10.1186/s12991-019-0235-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 07/02/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is associated with a high prevalence of depression, which is influenced by personality traits and coping style. However, these psychological factors have not been well studied in individuals with T2DM. The association between coping behaviors and the reported levels of depressive symptoms was examined in individuals with T2DM. METHODS The subjects were 435 T2DM patients (mean age 63.1 ± 12.6 years). Depressive status, personality traits and coping behaviors were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Brief Scale for Coping Profile (BSCP). Lifestyle factors and glycated hemoglobin A1c (HbA1c) levels in the patients were also included in the analyses. RESULTS Among the 435 subjects with T2DM, 130 (29.9%) exhibited possible depression, and 68 (15.6%) displayed probable depression. After adjustment for confounders, logistic and multiple regression analyses revealed that certain coping profile scores, such as Changing one's point of view, Emotional expression involving others and Avoidance and suppression, were consistently and significantly associated with the presence and severity of depression. No relationship was found between depression and HbA1c. CONCLUSION These findings indicate that Maladaptive emotion-focused coping strategies, such as Emotional expression involving others and Avoidance and suppression, are protective factors and that Adaptive emotion-focused coping, such as Changing one's point of view, is a risk factor for depression in T2DM patients. Psychological intervention focusing on the coping profile may reduce depressive symptoms. Additional studies are needed to examine the relationships between psychological factors and depressive symptoms using a longitudinal study design.
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Affiliation(s)
- Norio Yasui-Furukori
- 1Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,4Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Shimotsuga, Tochigi Japan
| | - Hiroshi Murakami
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hideyuki Otaka
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirofumi Nakayama
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masaya Murabayashi
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Satoru Mizushiri
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koki Matsumura
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Jutaro Tanabe
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuki Matsuhashi
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Miyuki Yanagimachi
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Nakamura
- 1Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Makoto Daimon
- 2Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Norio Sugawara
- 3Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan.,4Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Shimotsuga, Tochigi Japan
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210
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Yasui-Furukori N, Murakami H, Otaka H, Nakayama H, Murabayashi M, Mizushiri S, Matsumura K, Tanabe J, Matsuhashi Y, Yanagimachi M, Nakamura K, Daimon M, Sugawara N. Personality associated with depressive status in individuals with type 2 diabetes mellitus. Neuropsychiatr Dis Treat 2019; 15:1133-1139. [PMID: 31118646 PMCID: PMC6504551 DOI: 10.2147/ndt.s200012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/01/2019] [Indexed: 02/01/2023] Open
Abstract
Objective: Type 2 diabetes mellitus (T2DM) is associated with a high prevalence of depression, and depression is influenced by personality traits; however, these psychological factors have not been well studied in individuals with T2DM. The association between the use of a 5-factor model of personality and depressive symptoms was examined in individuals with T2DM. Methods: The subjects were 435 T2DM patients (mean age 63.1±12.6 years). Depressive status and personality traits were assessed using the Center for Epidemiologic Studies Depression Scale and the Ten-Item Personality Inventory, Japanese version, respectively. Lifestyle factors and glycated hemoglobin A1c levels in the patients were also included in the analyses. Results: Among the 435 subjects with T2DM, 130 (29.9%) exhibited possible depression, and 68 (15.6%) exhibited probable depression. After adjustment for confounders, Extraversion, Agreeableness and Neuroticism were found to be significantly associated with the presence of depression. No relationships were found between depression and HbA1c. Conclusion: These findings indicate that Extraversion and Agreeableness are protective factors, and Neuroticism is a risk factor for depression in T2DM patients. Psychological therapy focusing on personality may reduce depressive symptoms. Additional studies are needed to examine the relationships between psychological factors and depressive symptoms using a longitudinal study design.
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Affiliation(s)
- Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.,Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Murakami
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hideyuki Otaka
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirofumi Nakayama
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masaya Murabayashi
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Satoru Mizushiri
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koki Matsumura
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Jutaro Tanabe
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuki Matsuhashi
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Miyuki Yanagimachi
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Makoto Daimon
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.,Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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211
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Baucom KJW, Turner SL, Tracy EL, Berg CA, Wiebe DJ. Depressive symptoms and diabetes management from late adolescence to emerging adulthood. Health Psychol 2018; 37:716-724. [PMID: 30024228 DOI: 10.1037/hea0000645] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine changes in depressive symptoms as well as between- and within-person associations between depressive symptoms and Type 1 diabetes (T1D) management across the transition from late adolescence to emerging adulthood. METHOD Beginning in the senior year of high school, 197 late adolescents with T1D (Mage = 17.77) reported on their student status and living situation, and completed self-report measures of depressive symptoms and adherence to the diabetes regimen, annually at 3 time points. Glycemic control was gathered from hemoglobin A1c (HbA1c) assay kits at the same time points. RESULTS Results of multilevel models demonstrated high depressive symptoms at baseline, with significant increases in depressive symptoms across time when participants were not living in their parental home, but no change when living with parents. Participants with higher mean levels of depressive symptoms relative to peers (between-person association) had poorer adherence and glycemic control (i.e., higher HbA1c) on average. Within-person fluctuations in depressive symptoms were significantly associated with adherence: greater increases in depressive symptoms (relative to adolescents' own average) were associated with greater deteriorations in adherence. There was not a significant within-person effect of depressive symptoms on glycemic control. CONCLUSIONS The transition from late adolescence to emerging adulthood is particularly challenging for those with T1D. The findings that individuals with greater depressive symptoms have poorer adherence and glycemic control relative to those with lower depressive symptoms, and that increases in depressive symptoms are associated with declines in adherence, highlight the importance of screening and monitoring depressive symptoms during this life transition. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Deborah J Wiebe
- Psychological Sciences and the Health Sciences Research Institute, University of California, Merced
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212
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Pace R, Rahme E, Da Costa D, Dasgupta K. Association between gestational diabetes mellitus and depression in parents: a retrospective cohort study. Clin Epidemiol 2018; 10:1827-1838. [PMID: 30584375 PMCID: PMC6283257 DOI: 10.2147/clep.s184319] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Purpose The aim of this study was to examine the association between gestational diabetes mellitus (GDM) and depression incidence in mothers and fathers during prenatal and postnatal periods. Patients and methods Matched pairs (GDM vs no GDM) of randomly selected mothers with singleton live births (matched by age group, delivery year, and health region) and their partners (Quebec, Canada; cohort inception 1990-2007) were assessed for a composite outcome of depression/self-harm/suicide using a health administrative database. We examined the association of GDM and the composite outcome in the following three nonoverlapping periods: 1) 24 weeks gestation up to delivery; 2) delivery up to 1 year postpartum; and 3) 1 year postpartum to study end (March 31, 2012). We used stratified Cox proportional regression hazards models, with three models in mothers and three models in fathers, corresponding to each of the time periods of interest. Results In the 58,400 mothers, women with GDM had a nearly twofold greater risk (adjusted HR: 1.82, 95% CI 1.28, 2.59) of being diagnosed with depression compared to those without GDM during the prenatal period. In the first year postpartum, there was no conclusive difference observed between the two groups of mothers (adjusted HR: 1.05, 95% CI 0.84, 1.30). Beyond the first year postpartum, there was an 8% increased risk (adjusted HR: 1.08, 95% CI 1.03, 1.14) of depression in women with a history GDM compared to those without. A total of 63,384 fathers were included in our analyses, and no association between GDM in one's partner and depression was found during any of the three time periods evaluated. Conclusion GDM is associated with an increased risk of depression in women particularly during pregnancy highlighting the need to screen for depression and provide supportive interventions during this period.
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Affiliation(s)
- Romina Pace
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada,
| | - Elham Rahme
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada, .,Department of Medicine, McGill University Health Center, Montreal, QC, Canada,
| | - Deborah Da Costa
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada, .,Department of Medicine, McGill University Health Center, Montreal, QC, Canada,
| | - Kaberi Dasgupta
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada, .,Department of Medicine, McGill University Health Center, Montreal, QC, Canada,
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Gopalan A, Kellom K, McDonough K, Schapira MM. Exploring how patients understand and assess their diabetes control. BMC Endocr Disord 2018; 18:79. [PMID: 30400859 PMCID: PMC6219190 DOI: 10.1186/s12902-018-0309-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor understanding of diabetes management targets is associated with worse disease outcomes. Patients may use different information than providers to assess their diabetes control. In this study, we identify the information patients use to gauge their current level of diabetes control and explore patient-perceived barriers to understanding the hemoglobin A1c value (HbA1c). METHODS Adults who self-reported a diagnosis of diabetes were recruited from outpatient, academically-affiliated, Internal Medicine clinics. Semi-structured interviews were conducted with participants and collected data were analyzed using thematic analysis. RESULTS The mean age of the 25 participants was 56.8 years. HbA1c was one of several types of information participants used to assess diabetes control. Other information included perceived self-efficacy and adherence to self-care, the type and amount of medications taken, the presence or absence of symptoms attributed to diabetes, and feedback from self-monitoring of blood glucose. Most participants reported familiarity with the HbA1c (22 of 25), though understanding of the value's meaning varied significantly. Inadequate diabetes education and challenges with patient-provider communication were cited as common barriers to understanding the HbA1c. CONCLUSIONS In addition to the HbA1c, several categories of information influenced participants' assessments of their diabetes control. Increased provider awareness of the factors that influence patients' perceptions of diabetes control can inform effective, patient-centered approaches for communicating vital diabetes-related information, facilitating behavior change towards improved patient outcomes.
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Affiliation(s)
- Anjali Gopalan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 USA
- Michael J. Crescenz VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104 USA
| | - Katherine Kellom
- Policy Lab, The Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Kevin McDonough
- Division of General Internal Medicine, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Marilyn M. Schapira
- Michael J. Crescenz VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104 USA
- Division of General Internal Medicine, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
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214
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Weikert B, Buttery AK, Heidemann C, Rieckmann N, Paprott R, Maske UE, Scheidt-Nave C, Busch MA. Glycaemic status and depressive symptoms among adults in Germany: results from the German Health Interview and Examination Survey for Adults (DEGS1). Diabet Med 2018; 35:1552-1561. [PMID: 29888805 DOI: 10.1111/dme.13707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 12/15/2022]
Abstract
AIMS To examine the association between glycaemic status and depressive symptoms in a nationwide sample of the adult population in Germany. METHODS We conducted a cross-sectional analysis of data from 6385 participants aged 18-79 years in the nationwide German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). Glycaemic status was classified as follows: diagnosed diabetes (self-reported diagnosis or receiving antidiabetes medication); undiagnosed diabetes (HbA1c ≥48 mmol/mol [≥6.5%]); prediabetes (HbA1c 39-47 mmol/mol [5.7-6.4%]); or normoglycaemia (HbA1c <39 mmol/mol [<5.7%]). Current depressive symptoms were measured using the Patient Health Questionnaire depression scale (PHQ-9) and defined as elevated depressive symptoms (PHQ-9 score ≥10 points; dichotomous variable) and severity of depressive symptoms (PHQ-9 score, range 0-27 points; continuous variable). Associations of glycaemic status and HbA1c with both depressive symptoms variables were analysed using multivariable logistic (elevated depressive symptoms) and linear (severity of depressive symptoms) regression models. RESULTS Compared with normoglycaemia, diagnosed diabetes, but not prediabetes or undiagnosed diabetes, was associated with elevated depressive symptoms (odds ratio 1.55, 95% CI 1.00-2.41) and severity of depressive symptoms (β coefficient 0.71, 95% CI 0.23-1.19) in models adjusting for sociodemographics and health behaviours. Associations were similar among people with diagnosed diabetes taking and not taking antidiabetes medication. Among people without diagnosed diabetes, no associations between HbA1c and depressive symptoms were found. CONCLUSIONS Diagnosed diabetes, but not prediabetes, undiagnosed diabetes or HbA1c , was associated with depressive symptoms among adults in Germany. Studies examining psychosocial and biological mechanisms that may potentially explain relationships between diagnosed diabetes and depressive symptoms are needed.
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Affiliation(s)
- B Weikert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - A K Buttery
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - C Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - N Rieckmann
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - R Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - U E Maske
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - M A Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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215
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Gamble JM, Chibrikov E, Midodzi WK, Twells LK, Majumdar SR. Examining the risk of depression or self-harm associated with incretin-based therapies used to manage hyperglycaemia in patients with type 2 diabetes: a cohort study using the UK Clinical Practice Research Datalink. BMJ Open 2018; 8:e023830. [PMID: 30297350 PMCID: PMC6194463 DOI: 10.1136/bmjopen-2018-023830] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To compare population-based incidence rates of new-onset depression or self-harm in patients initiating incretin-based therapies with that of sulfonylureas (SU) and other glucose-lowering agents. DESIGN Population-based cohort study. SETTING Patients attending primary care practices registered with the UK-based Clinical Practice Research Datalink (CPRD). PARTICIPANTS Using the UK-based CPRD, we identified two incretin-based therapies cohorts: (1) dipeptidyl peptidase-4 inhibitor (DPP-4i)-cohort, consisting of new users of DPP-4i and SU and (2) glucagon-like peptide-1 receptor agonists (GLP-1RA)-cohort, consisting of new users of GLP-1RA and SU, between January 2007 and January 2016. Patients with a prior history of depression, self-harm and other serious psychiatric conditions were excluded. MAIN OUTCOME MEASURES The primary study outcome comprised a composite of new-onset depression or self-harm. Unadjusted and adjusted Cox proportional hazards regression was used to quantify the association between incretin-based therapies and depression or self-harm. Deciles of High-Dimensional Propensity Scores and concurrent number of glucose-lowering agents were used to adjust for potential confounding. RESULTS We identified new users of 6206 DPP-4i and 22 128 SU in the DPP-4i-cohort, and 501 GLP-1RA and 16 409 SU new users in the GLP-1RA-cohort. The incidence of depression or self-harm was 8.2 vs 11.7 events/1000 person-years in the DPP-4i-cohort and 18.2 vs 13.6 events/1000 person-years in the GLP-1RA-cohort for incretin-based therapies versus SU, respectively. Incretin-based therapies were not associated with an increased or decreased incidence of depression or self-harm compared with SU (DPP-4i-cohort: unadjusted HR 0.70, 95% CI 0.51 to 0.96; adjusted HR 0.80, 95% CI 0.57 to 1.13; GLP-1RA-cohort: unadjusted HR 1.36, 95% CI 0.72 to 2.58; adjusted HR 1.25, 95% CI 0.63 to 2.50). Consistent results were observed for other glucose-lowering comparators including insulin and thiazolidinediones. CONCLUSIONS Our findings suggest that the two incretin-based therapies are not associated with an increased or decreased risk of depression or self-harm.
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Affiliation(s)
- John-Michael Gamble
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Eugene Chibrikov
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - William K Midodzi
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Laurie K Twells
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Sumit R Majumdar
- Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Polak R, Tirosh A, Livingston B, Pober D, Eubanks JE, Silver JK, Minezaki K, Loten R, Phillips EM. Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential. Curr Diab Rep 2018; 18:99. [PMID: 30218282 DOI: 10.1007/s11892-018-1061-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Various dietary regimes have proven effective in preventing diabetes, yet its prevalence is growing. This review's goals are to examine the relationship between home cooking and diabetes and to present the literature on home cooking education programs as a novel strategy to improve adherence to healthy nutrition, thus decreasing the risk of diabetes. RECENT FINDINGS Consumption of home-cooked food is linked to healthier nutrition and decreased risk of diabetes. Further, home cooking interventions have a short-term positive impact on nutritional intake of both children and adults, and on diabetes prevention. Well-designed randomized controlled studies are needed to rigorously evaluate the long-term impact of home cooking interventions on cooking behavior, dietary intake, diabetes, and healthcare costs. Culinary education is an emerging field that aims to change nutrition education paradigms. Clinicians can empower patients to adopt home cooking by role modeling home cooking themselves, including home cooking content in their medical encounters, and through comprehensive lifestyle medicine interventions.
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Affiliation(s)
- Rani Polak
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA.
- Lifestyle Medicine Center, Sheba Medical Center, Tel Hashomer, Israel.
| | - Amir Tirosh
- Endocrinology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | | | - David Pober
- Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - James E Eubanks
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA
- Massachusetts General Hospital, Boston, MA, USA
- Brigham and Women's Hospitals, Boston, MA, USA
| | - Kaya Minezaki
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Loten
- The Institute of Biochemistry, Food and Nutrition Science; The Robert H. Smith Faculty of Agriculture Food and the Environment, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Joseph Sagol Neuroscience Center Tel Hashomer, Tel Hashomer, Israel
| | - Edward M Phillips
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA
- Massachusetts General Hospital, Boston, MA, USA
- Brigham and Women's Hospitals, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
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217
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KhalediSardashti F, Ghazavi Z, Keshani F, Smaeilzadeh M. Effect of Hope Therapy on the Mood Status of Patients with Diabetes. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:281-286. [PMID: 30034488 PMCID: PMC6034523 DOI: 10.4103/ijnmr.ijnmr_36_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: Diabetes mellitus (DM) is a chronic disease which imposes high costs on patients and society and results in complications in patients. One of these complications includes issues related to mood. Thus, the present study was conducted with the aim to determine the effect of hope therapy on the mood status of patients with DM. Materials and Methods: This quasi-experimental study was performed with two groups in three stages in the summer of 2015 on 38 individuals. The study population consisted of all individuals with DM who referred to and had a medical record at Shahid Asghar Shabani Clinic (Isfahan, Iran) affiliated with the social security organization. From among the 350 individuals with medical records at the clinic, 38 who had the inclusion criteria were selected through simple random sampling. Participants were randomly assigned to control (n = 19) and experimental (n = 19) groups. The Zung Self-Rating Depression Scale was completed by both groups before, after, and 1 month after the intervention. Results: There was a significant difference in the mean scores of depression in the intervention group before (F = 19.48, p = 0.001), immediately after (t = 3.30, p = 0.002), and 1 month after the intervention (t = 3.09, p = 0.004), whereas there was no significant difference in the mean scores of depression before, immediately after, and 1 month after the intervention in the control group. Conclusions: The obtained results showed that hope therapy can reduce depression in patients with DM.
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Affiliation(s)
- Firouz KhalediSardashti
- Department of Nursing, School of Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Zahra Ghazavi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshad Keshani
- Student of Artificial Intelligent, Isfahan University, Isfahan, Iran
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218
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Makrilakis K, Liatis S, Tsiakou A, Stathi C, Papachristoforou E, Perrea D, Katsilambros N, Kontodimopoulos N, Niakas D. Comparison of health-related quality of Life (HRQOL) among patients with pre-diabetes, diabetes and normal glucose tolerance, using the 15D-HRQOL questionnaire in Greece: the DEPLAN study. BMC Endocr Disord 2018; 18:32. [PMID: 29843700 PMCID: PMC5975583 DOI: 10.1186/s12902-018-0261-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/18/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diabetes mellitus is usually preceded by a pre-diabetic stage before the clinical presentation of the disease, the influence of which on persons' quality of life is not adequately elucidated. The purpose of this study was to compare the Health-Related Quality of Life (HRQOL) of persons with pre-diabetes with that of diabetes or normal glucose tolerance (NGT), using the validated HRQOL-15D questionnaire. METHODS The HRQOL-15D scores of 172 people with pre-diabetes (108 with Impaired Fasting Glucose [IFG], 64 with Impaired Glucose Tolerance [IGT], aged 58.3 ± 10.3 years) and 198 with NGT (aged 54.4 ± 10.1 years) from the Greek part of the DEPLAN study (Diabetes in Europe - Prevention using Lifestyle, Physical Activity and Nutritional Intervention), were compared to 100 diabetes patients' scores (aged 60.9 ± 12.5 years, diabetes duration 17.0 ± 10.0 years, HbA1c 7.2 ± 1.2%), derived from the outpatient Diabetes Clinic of a University Hospital. RESULTS The diabetes patients' HRQOL-15D score (0.8605) was significantly lower than the pre-diabetes' (0.9008) and the controls' (0.9092) (p < 0.001). There were no differences in the total score between the controls and the group with pre-diabetes. However, examination of individual parameters of the score showed that people with IGT had lower scores compared to the control group, as related to the parameters of "mobility" and "psychological distress". No differences were found in any component of the HRQOL-15D score between the control group and the IFG group, nor between the two groups with pre-diabetes (IFG vs. IGT). CONCLUSIONS Persons with pre-diabetes had a similar HRQOL score with healthy individuals, and a higher score than persons with diabetes. Specific components of the score, however, were lower in the IGT group compared to the controls. These findings help clarify the issue of HRQOL of persons with pre-diabetes and its possible impact on prevention.
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Affiliation(s)
- Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Afroditi Tsiakou
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Chryssoula Stathi
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Eleftheria Papachristoforou
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Despoina Perrea
- Laboratory for Experimental Surgery and Surgical Research “Christeas Hall”, University of Athens Medical School, Athens, Greece
| | - Nicholas Katsilambros
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
- Laboratory for Experimental Surgery and Surgical Research “Christeas Hall”, University of Athens Medical School, Athens, Greece
| | | | - Dimitrios Niakas
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
- Hellenic Open University, Patras, Greece
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219
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Nanayakkara N, Pease A, Ranasinha S, Wischer N, Andrikopoulos S, Speight J, de Courten B, Zoungas S. Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016. Sci Rep 2018; 8:7846. [PMID: 29777153 PMCID: PMC5959930 DOI: 10.1038/s41598-018-26138-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/30/2018] [Indexed: 01/15/2023] Open
Abstract
This study explores the prevalence of, and factors associated with, likely depression and diabetes distress in adults with type 2 diabetes in a large, national sample. Australian National Diabetes Audit data were analysed from adults with type 2 diabetes attending 50 diabetes centres. The Brief Case find for Depression and Diabetes Distress Score 17 were administered to screen for likely depression and diabetes-related distress, respectively. A total of 2,552 adults with type 2 diabetes participated: (mean ± SD) age was 63 ± 13 years, diabetes duration was 12 ± 10 years, and HbA1c was 8 ± 2%. Twenty-nine percent of patients had likely depression, 7% had high diabetes distress, and 5% had both. Difficulty following dietary recommendations, smoking, forgetting medications, and diabetes distress were all associated with greater odds of depression whereas higher own health rating was associated with lower odds (all p < 0.02). Female gender, increasing HbA1c, insulin use, difficulty following dietary recommendations and depression were all associated with greater odds of diabetes distress & older age, higher own health rating and monitoring blood glucose levels as recommended were associated with lower odds (all p < 0.04). Depression was associated with sub-optimal self-care, while diabetes distress was associated with higher HbA1c and sub-optimal self-care.
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Affiliation(s)
- Natalie Nanayakkara
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia
| | - Anthony Pease
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia
| | - Sanjeeva Ranasinha
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia
| | - Natalie Wischer
- National Association Diabetes Centres, Sydney, NSW, 2000, Australia
| | - Sofianos Andrikopoulos
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,The University of Melbourne, Department of Medicine, Heidelberg, VIC, 3168, Australia
| | - Jane Speight
- Deakin University, School of Psychology, Geelong, Victoria, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.,AHP Research, Hornchurch, UK
| | - Barbora de Courten
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia
| | - Sophia Zoungas
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia. .,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia. .,The George Institute for Global Health, Camperdown, NSW, 2050, Australia.
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220
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Factors associated with depression among homeless mothers. Results of the ENFAMS survey. J Affect Disord 2018; 229:314-321. [PMID: 29329065 DOI: 10.1016/j.jad.2017.12.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/12/2017] [Accepted: 12/27/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE Women are disproportionately likely to suffer from depression. This is especially true for those who experience socioeconomic hardship, such as homelessness. In France, among homeless mothers many are migrant. However, it is not clear whether risk factors associated with depression are specific for this group or the same as in the general population. Our objective was to describe socio-demographic, relational, living and housing conditions and health factors associated with depression among homeless mothers. METHODS The ENFAMS survey, conducted via face-to-face bilingual interviews with a representative sample of homeless families in the Paris region (January-May 2013, n = 733 mothers). Mothers reported their socio-demographic characteristics, housing conditions including residential mobility, as well as physical and mental health. Depression was ascertained using the Composite International Diagnostic Interview (CIDI). Factors associated with mother's depression were studied in weighted Poisson regression models with robust error variance. RESULTS The prevalence of depression among participating mothers was 28.8%. In multivariate analyses, depression was associated with fluency in French (PR = 1.88 95% CI 1.40; 2.51), suicide risk (PR = 2.26, 95% CI 1.82; 2.82), post-traumatic stress disorder (PR = 1.97, 95% CI 1.50; 2.60), and unmet health needs (PR = 1.68, 95% CI 1.09; 2.57). CONCLUSIONS Homeless mothers have high levels of depression and associated psychiatric comorbidities. Associated risk factors appear to be both specific for this group and shared with mothers in the general population. Improvements in the monitoring of mental health difficulties as well as access to appropriate medical care in this vulnerable population may help improve health and social outcomes.
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221
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Mahlich J, Tsukazawa S, Wiegand F. Estimating Prevalence and Healthcare Utilization for Treatment-Resistant Depression in Japan: A Retrospective Claims Database Study. Drugs Real World Outcomes 2018; 5:35-43. [PMID: 29185233 PMCID: PMC5825389 DOI: 10.1007/s40801-017-0126-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Major depressive disorders (MDDs) including treatment-resistant depression (TRD) are common disabling conditions, but data on their epidemiology in Japan are limited. This study investigated the incidence, epidemiology, and direct medical costs of TRD and pharmaceutically-treated depression (PTD) in Japan to increase our health economic understanding of this phenotype of MDD. METHODS A retrospective cohort study from a private health insurance claims database estimated the 1-year incidence of PTD and TRD and described the health services used and direct medical costs associated with these conditions. RESULTS In the year from 1 April 2012 through 31 March 2013, we identified 1143 incident PTD cases among 98,552 eligible subjects, i.e. 11.59 cases/1000 patient-years. Of the PTD patients, 51.4% were women. Within the 1-year observation interval 137 patients failed more than two antidepressive treatment approaches and thus developed TRD. Though co-morbid conditions and age were similar among PTD and TRD patients, medical costs per patient (patient-year) during their treatment intervals were 1.01 million JPY (0. 540 million JPY) in the TRD population and 0.643 JPY million JPY (0.645 million JPY) in the PTD population who did not convert into TRD. CONCLUSIONS This study describes the PTD and TRD patient populations in a large claims database in Japan and highlights an unmet medical need for the treatment of TRD to provide better preventative measures and interventions for the treatment of depression.
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Affiliation(s)
- Jörg Mahlich
- Health Economics, Janssen Pharmaceutical K.K, 5-2, Nishi-kanda 3-chome, Chiyoda-ku, Tokyo, 101-0065, Japan.
- Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany.
| | - Sunny Tsukazawa
- Health Economics, Janssen Pharmaceutical K.K, 5-2, Nishi-kanda 3-chome, Chiyoda-ku, Tokyo, 101-0065, Japan
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Rathmann W, Kuß O, Anderson D, Busch S, Hahn M, Engelhard J, Zou M, Kostev K. Increased depression symptom score in newly diagnosed type 2 diabetes patients. Psychiatry Res 2018; 261:259-263. [PMID: 29329045 DOI: 10.1016/j.psychres.2017.12.091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/19/2017] [Accepted: 12/31/2017] [Indexed: 10/18/2022]
Abstract
The aim was to investigate the association between diabetes duration and depressive symptoms in type 2 diabetes. The DIAREG registry used data of a nationwide general medicine practice database (Disease Analyzer, Germany) augmented by prospective data from patient reported outcomes (PRO) including Center of Epidemiological Studies Depression Scale (CES-D: <16 vs. ≥16) and the SF-36. Multiple logistic regression models were used to investigate the association of diabetes duration with PROs. Overall, 1807 type 2 diabetes patients were registered in 108 practices. From 270 (15%) patients complete PRO could be collected, which were similar with respect to age, sex, body mass index, HbA1c, diabetes duration and treatment to patients with incomplete data (p≥0.05). Patients with a longer diabetes duration (reference: <2 years) displayed a significantly increased odds of having no indication of depression (CES-D <16: 66%) (Odds Ratio, 95%CI: 2-<5 years: 5.9, 1.2-29.6; 5-<10 years: 6.2, 1.3-28.7; ≥10 years: 5.6, 1.2-23.1), after adjusting for age, sex, BMI, diabetes complications, antidepressants and glucose-lowering treatment. Patients with <2 years diabetes duration also exhibited a significantly decreased mean mental component score (SF-36: <2 years: 50, 2-<5 years: 69). In type 2 diabetes with a short duration an increased depressive symptom score was observed.
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Affiliation(s)
- Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.
| | - Oliver Kuß
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
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Abiodun O, Lawal I, Omokanye C. PLHIV are more likely to have mental distress: evidence from a comparison of a cross-section of HIV and diabetes patients at Tertiary Hospitals in Nigeria. AIDS Care 2018; 30:1050-1057. [PMID: 29458268 DOI: 10.1080/09540121.2018.1441973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HIV is now regarded as a chronic disease because of the availability of treatment. However, it is not well known if there are differences (clinically and in magnitude) between the mental health status of PLHIV and people living with other chronic diseases. The aim of this study was to compare the mental health status of patients attending antiretroviral clinics to patients attending diabetes clinics at tertiary hospitals in Ogun State, Nigeria. A comparative hospital-based cross-sectional study of mental distress among 639 HIV-positive and 639 diabetic patients was carried out. Multivariate logistic regression analysis was used to control for confounders and to predict the probability of mental distress in PLHIV. The mean age of the participants was 44.87 (± 13.83) years and it had a range of 63 years (17 to 80). The prevalence of mental distress was higher among HIV-positive participants (46.79%) than diabetic participants (33.02%) (p < 0.0001). HIV-positive participants had greater odds of mental distress than diabetics (odds ratio = 1.78; 95% CI = 1.41-2.25). HIV-positivity, female sex, lower levels of education, being unemployed, poorer housing conditions and separated, widowed or divorced were associated with higher odds of mental distress (p < 0.05). Mental distress was predicted by HIV-positivity, occupation and current marital status. HIV infection and social inequalities are independent risk factors for mental distress. The odds of having mental distress is higher among PLHIV compared with diabetic patients. Addressing social inequalities might be the critical factor in the control of mental distress among PLHIV. ABBREVIATIONS ART: Anti-retroviral therapy; CI: Confidence interval; YLD: Years Lived with Disability; GHQ: General Health Questionnaire; HIV/AIDS: Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome; LMIC: Low and middle-income countries; MH: Mantel-Haenszel; PLHIV: People living with HIV; ROC: Receiver operating characteristic.
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Affiliation(s)
- Olumide Abiodun
- a Department of Community Medicine , Babcock University , Ilishan , Nigeria
| | - Ismail Lawal
- b Department of Medical Microbiology , Olabisi Onabanjo University Teaching Hospital , Sagamu , Nigeria
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The association of depression and diabetes across methods, measures, and study contexts. Clin Diabetes Endocrinol 2018; 4:1. [PMID: 29318033 PMCID: PMC5755050 DOI: 10.1186/s40842-017-0052-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/14/2017] [Indexed: 01/09/2023] Open
Abstract
Background Empirical research has revealed a positive relationship between type 2 diabetes mellitus and depression, but questions remain regarding timing of depression measurement, types of instruments used to measure depression, and whether “depression” is defined as clinical depression or depressive symptoms. The present study sought to establish the robustness of the depression-diabetes relationship across depression definition, severity of depressive symptoms, recent depression, and lifetime depression in a nationally representative dataset and a large rural dataset. Methods The present examination, conducted between 2014 and 2015, used two large secondary datasets: the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 (n = 3072) and the Arthritis, Coping, and Emotion Study (ACES) from 2002 to 2006 (n = 2300). Depressive symptoms in NHANES were measured using the Patient Health Questionnaire 9-item survey (PHQ-9). ACES used the Center for Epidemiologic Studies—Depression Scale (CES-D) to measure depressive symptoms and the Composite International Diagnostic Interview (CIDI) to measure diagnosable depression. Diabetes was modelled as the dichotomous outcome variable (presence vs. absence of diabetes). Logistic regression was used for all analyses, most of which were cross-sectional. Analyses controlled for age, ethnicity, sex, education, and body mass index, and NHANES analyses used sample weights to account for the complex survey design. Additional analyses using NHANES data focused on the addition of health behavior variables and inflammation to the model. Results NHANES. Every one-point increase in depressive symptoms was associated with a 5% increase in odds of having diabetes [OR: 1.05 (CI: 1.03, 1.07)]. These findings persisted after controlling for health behaviors and inflammation. ACES. For every one-point increase in depressive symptom score, odds of having diabetes increased by 2% [OR: 1.02 (CI: 1.01, 1.03)]. Recent (past 12 months) depression [OR: 1.49, (CI: 1.03, 2.13)] and lifetime depression [OR: 1.40 (CI: 1.09, 1.81)] were also significantly associated with having diabetes. Conclusions This study provides evidence for the robustness of the relationship between depression or depressive symptoms and diabetes and demonstrates that depression occurring over the lifetime can be associated with diabetes just as robustly as that which occurs more proximal to the time of study measurement.
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Lewandowicz A, Skowronek P, Maksymiuk-Kłos A, Piątkiewicz P. The Giant Geriatric Syndromes Are Intensified by Diabetic Complications. Gerontol Geriatr Med 2018; 4:2333721418817396. [PMID: 30560147 PMCID: PMC6291866 DOI: 10.1177/2333721418817396] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/02/2018] [Accepted: 11/13/2018] [Indexed: 12/19/2022] Open
Abstract
By 2015, diabetes has affected more than 415 million people over the world. It is anticipated that 640 million adults will suffer from diabetes in 2040. The elongation of the life expectancy, as the result of better general health care, extends also the time when diabetic complications may develop together with other senility-specific problems. The Giant Geriatric Syndromes (Geriatric Giants) have been qualified by the original Nascher's criteria defined more than 100 years ago, but they are becoming more and more relevant in connection with the aging of societies. The criteria comprise the older age, commonness of the health problem, multifactorial etiology, functional or cognitive impairment, worsened outcome, and increased morbidity and mortality. We described the impact of diabetes on Geriatric Giants including cognitive dysfunction, depression, malnutrition, incontinence, falls and fractures, chronic pain, and the loss of senses. The association of diabetes with Geriatric Giants reveals as a vicious circle with the background of neurovascular complications. However, diabetes influence on the incidence of cancer in elderly was also discussed, since neoplastic diseases associate with Geriatric Giants, for example, chronic pain and depression. The knowledge about these aspects of functional decline in geriatric population is crucial to improve patient care.
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Affiliation(s)
- Andrzej Lewandowicz
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Paweł Skowronek
- Regional Hospital WSZZ Kielce, Poland
- Kochanowski University, Kielce, Poland
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Sun KL, Watson KT, Angal S, Bakkila BF, Gorelik AJ, Leslie SM, Rasgon NL, Singh MK. Neural and Endocrine Correlates of Early Life Abuse in Youth With Depression and Obesity. Front Psychiatry 2018; 9:721. [PMID: 30622489 PMCID: PMC6308296 DOI: 10.3389/fpsyt.2018.00721] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/07/2018] [Indexed: 12/04/2022] Open
Abstract
Depression and insulin resistance are becoming increasingly prevalent in younger populations. The origin and consequence of insulin resistance in depressed youth may, in part, be rooted in exposure to environmental stressors, such as early life abuse, that may lead to aberrant brain motivational networks mediating maladaptive food-seeking behaviors and insipient insulin resistance. In this paper, we aimed to investigate the impact of early life abuse on the development of insulin resistance in depressed and overweight youth aged 9 to 17 years. We hypothesized that youth with the greatest burden of early life abuse would have the highest levels of insulin resistance and corresponding aberrant reward network connectivities. To test this hypothesis, we evaluated sixty-nine depressed and overweight youth aged 9 to 17, using multimodal assessments of early life abuse, food-seeking behavior, and insulin resistance. Based on results of the Childhood Trauma Questionnaire (CTQ), we separated our study participants into two groups: 35 youth who reported high levels of the sum of emotional, physical, or sexual abuse and 34 youth who reported insignificant or no levels of any abuse. Results of an oral glucose tolerance test (OGTT) and resting state functional connectivity (RSFC), using the amygdala, insula, and nucleus accumbens (NAcc) as seed-based reward network regions of interest, were analyzed for group differences between high abuse and low abuse groups. High abuse youth exhibited differences from low abuse youth in amygdala-precuneus, NAcc-paracingulate gyrus, and NAcc-prefrontal cortex connectivities, that correlated with levels of abuse experienced. The more different their connectivity from of that of low abuse youth, the higher were their fasting glucose and glucose at OGTT endpoint. Importantly, level of abuse moderated the relation between reward network connectivity and OGTT glucose response. In contrast, low abuse youth showed hyperinsulinemia and more insulin resistance than high abuse youth, and their higher OGTT insulin areas under the curve correlated with more negative insula-precuneus connectivity. Our findings suggest distinct neural and endocrine profiles of youth with depression and obesity based on their histories of early life abuse.
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Affiliation(s)
- Kevin L Sun
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Kathleen T Watson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Sarthak Angal
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Baylee F Bakkila
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Aaron J Gorelik
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Sara M Leslie
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Natalie L Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes. Ann Behav Med 2017; 50:762-774. [PMID: 27333897 DOI: 10.1007/s12160-016-9801-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Prospective data suggest depressive symptoms worsen insulin resistance and accelerate type 2 diabetes (T2D) onset. PURPOSE We sought to determine whether reducing depressive symptoms in overweight/obese adolescents at risk for T2D would increase insulin sensitivity and mitigate T2D risk. METHOD We conducted a parallel-group, randomized controlled trial comparing a 6-week cognitive-behavioral (CB) depression prevention group with a 6-week health education (HE) control group in 119 overweight/obese adolescent girls with mild-to-moderate depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D] ≥16) and T2D family history. Primary outcomes were baseline to post-intervention changes in CES-D and whole body insulin sensitivity index (WBISI), derived from 2-h oral glucose tolerance tests. Outcome changes were compared between groups using ANCOVA, adjusting for respective baseline outcome, puberty, race, facilitator, T2D family history degree, baseline age, adiposity, and adiposity change. Multiple imputation was used for missing data. RESULTS Depressive symptoms decreased (p < 0.001) in CB and HE from baseline to posttreatment, but did not differ between groups (ΔCESD = -12 vs. -11, 95 % CI difference = -4 to +1, p = 0.31). Insulin sensitivity was stable (p > 0.29) in CB and HE (ΔWBISI = 0.1 vs. 0.2, 95 % CI difference = -0.6 to +0.4, p = 0.63). Among all participants, reductions in depressive symptoms were associated with improvements in insulin sensitivity (p = 0.02). CONCLUSIONS Girls at risk for T2D displayed reduced depressive symptoms following 6 weeks of CB or HE. Decreases in depressive symptoms related to improvements in insulin sensitivity. Longer-term follow-up is needed to determine whether either program causes sustained decreases in depressive symptoms and improvements in insulin sensitivity. TRIAL REGISTRATION NUMBER The trial was registered with clinicaltrials.gov (NCT01425905).
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228
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Sattler MC, Jelsma JGM, Bogaerts A, Simmons D, Desoye G, Corcoy R, Adelantado JM, Kautzky-Willer A, Harreiter J, van Assche FA, Devlieger R, Jans G, Galjaard S, Hill D, Damm P, Mathiesen ER, Wender-Ozegowska E, Zawiejska A, Blumska K, Lapolla A, Dalfrà MG, Bertolotto A, Dunne F, Jensen DM, Andersen LLT, Snoek FJ, van Poppel MNM. Correlates of poor mental health in early pregnancy in obese European women. BMC Pregnancy Childbirth 2017; 17:404. [PMID: 29202779 PMCID: PMC5715612 DOI: 10.1186/s12884-017-1595-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/24/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. METHODS In this cross-sectional observational study, baseline data from early pregnancy (< 20 weeks) of the DALI (Vitamin D and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. RESULTS A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25, .77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92, .98], social support, OR = .94, 95% CI [.90, .99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]). CONCLUSIONS Mental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. TRIAL REGISTRATION ISRCTN70595832 , 02.12.2011.
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Affiliation(s)
- Matteo C. Sattler
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Judith G. M. Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
| | - Annick Bogaerts
- Department of Development and Regeneration KULeuven, University of Leuven, Leuven, Belgium and Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium and Faculty of Health and Social Work, research unit Healthy Living, UC Leuven-Limburg, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England and Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universität Graz, Graz, Austria
| | - Rosa Corcoy
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragaza, Spain
| | - Juan M. Adelantado
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Jürgen Harreiter
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Frans A. van Assche
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Goele Jans
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
- Department of Obstetrics and Gynaecology Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - David Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Agnieszka Zawiejska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Blumska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | | | | | | | - Frank J. Snoek
- Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Medical Psychology, Academic Medical Centre, Amsterdam, the Netherlands
| | - Mireille N. M. van Poppel
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
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229
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Depression and anxiety disorders in people with diabetes. CURRENT PROBLEMS OF PSYCHIATRY 2017. [DOI: 10.1515/cpp-2017-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: As the global number of diabetes and the burden of depression together with other mental disorders increases, there is a need for better understanding of the connection between these diseases. In patients with diabetes, mental disorders are more common than in the general population, especially anxiety disorders and depression, which are often difficult to detect by health professionals.
Material and methods: Using the keywords searched in the international bibliographic databases: Embase, Medline, Science Direct, Web of Science. We analyzed clinical trials published in English and international journals
Results: Patients with diabetes are exposed to serious physical and mental complications. The occurence of depression and psychiatric disorders among people with diabetes was twice as frequent as in the general population. There are also studies showing a higher risk of suicide among people with diabetes. In addition, patients with both diseases, diabetes and depression, had an increased risk of cardiovascular complications and increased mortality and higher costs of health care. Diabetic patients have increased incidence of anxiety disorders in relation to non-diabetic patients by 20%.
Conclusion: Further researches and integration of medical and psychological treatment are needed. Cooperation between psychiatrists and diabetologists can reduce mental and physical harm in patients with diabetes.
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Perrin NE, Davies MJ, Robertson N, Snoek FJ, Khunti K. The prevalence of diabetes-specific emotional distress in people with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2017; 34:1508-1520. [PMID: 28799294 DOI: 10.1111/dme.13448] [Citation(s) in RCA: 264] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 01/05/2023]
Abstract
AIMS Psychological comorbidity, such as depression and/or diabetes-specific emotional distress (diabetes distress), is widespread in people with Type 2 diabetes and is associated with poorer treatment outcomes. Although extensive research into the prevalence of depression has been conducted, the same attention has not been given to diabetes distress. The aim of this systematic review was to determine the overall prevalence of diabetes distress in people with Type 2 diabetes. METHODS Seven databases were searched to identify potentially relevant studies; eligible studies (adult population aged > 18 years with Type 2 diabetes and an outcome measure of diabetes distress) were selected and appraised independently by two reviewers. Multiple fixed- and random-effects meta-analyses were performed to synthesize the data; with primary analyses to determine the overall prevalence of diabetes distress in people with Type 2 diabetes, and secondary meta-analyses and meta-regression to explore the prevalence across different variables. RESULTS Fifty-five studies (n = 36 998) were included in the meta-analysis and demonstrated an overall prevalence of 36% for diabetes distress in people with Type 2 diabetes. Prevalence of diabetes distress was significantly higher in samples with a higher prevalence of comorbid depressive symptoms and a female sample majority. CONCLUSIONS Diabetes distress is a prominent issue in people with Type 2 diabetes that is associated with female gender and comorbid depressive symptoms. It is important to consider the relationship between diabetes distress and depression, and the significant overlap between conditions. Further work is needed to explore psychological comorbidity in Type 2 diabetes to better understand how best to identify and appropriately treat individuals.
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Affiliation(s)
- N E Perrin
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - N Robertson
- School of Psychology, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - F J Snoek
- Department of Medical Psychology, VU University Medical Centre, Academic Medical Centre Amsterdam, the Netherlands
| | - K Khunti
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
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Adua E, Roberts P, Sakyi SA, Yeboah FA, Dompreh A, Frimpong K, Anto EO, Wang W. Profiling of cardio-metabolic risk factors and medication utilisation among Type II diabetes patients in Ghana: a prospective cohort study. Clin Transl Med 2017; 6:32. [PMID: 28879491 PMCID: PMC5587509 DOI: 10.1186/s40169-017-0162-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/29/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Type II diabetes mellitus (T2DM) is complicated by multiple cardio-metabolic risk factors. Controlling these factors requires lifestyle modifications alongside utilisation of anti-diabetic medications. Different glucose lowering [(biguanides (BIGs), sulfonylureas (SUAs), thiazolidinediones (TNZ)], lipid lowering (statins), and anti-hypertensive medicines [angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs) and central acting drugs (CADs)] have been approved for controlling hyperglycaemia, dyslipidaemia and hypertension respectively. Here, we examined factors that characterise T2DM and explored the response to medication therapy among T2DM patients. METHODS This prospective cohort study recruited 241 T2DM patients reporting at a clinic in Ghana, from January through to August, 2016. Each patient's demographic, medications and anthropometric data was obtained while information on medication adherence was captured using Morisky adherence scale-8 (MMAS-8). Fasting blood samples were collected for biochemical analysis. RESULTS The mean age of participants was 57.82 years for baseline and six-month follow-up. Physical activity differed at baseline and follow up (p < 0.05) but not body mass index (BMI). BIG alone, or in combination with SUA and TNZ did not improve glycaemic status at follow up (p > 0.05). Many participants using either ACEI or ARB were able to control their blood pressures. Among dyslipidaemia patients under statin treatment, there was an improved lipid profile at follow-up. CONCLUSIONS Statin medications are effective for reducing dyslipidaemia in T2DM patients. However, control of modifiable risk factors, particularly blood glucose and to a lesser degree blood pressure is suboptimal. Addressing these will require concomitant interventions including education on medication adherence and correct dietary plans, lifestyle modifications and physical activity.
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Affiliation(s)
- Eric Adua
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027 WA Australia
| | - Peter Roberts
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027 WA Australia
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Agyemang Yeboah
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Albert Dompreh
- Department of Serology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Kwasi Frimpong
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027 WA Australia
| | - Enoch Odame Anto
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027 WA Australia
| | - Wei Wang
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, 6027 WA Australia
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Abstract
BACKGROUND Type 2 diabetes is a huge burden both for individuals and society as a whole. Although depression has been negatively associated with ideal glycemic control, little is known about the prevalence of depression or its associated factors among rural Taiwanese adults with Type 2 diabetes mellitus (type2 DM). PURPOSE The purposes of this study were to investigate the prevalence of depression in rural-dwelling sufferers of type2 DM and to highlight the relationships between their depression status and health promoting behaviors such as physical activity, keeping active in life, sleep sufficiency, and adopting a diabetic diet. METHODS A cross-sectional, correlational design was used to recruit 696 participants from local healthcare centers in rural areas of Chiayi County, Taiwan. Data were collected from March 30, 2010, to August 30, 2012. The Chinese version of the Geriatric Depression Scale and its associated physiological biomarkers were used as screening tools. Logistic regression was used to identify the factors that were associated with depression status. RESULTS The prevalence of depression in this study was 16.8%. Factors found to be associated with depression included being female, having a low level of education, receiving reduced family support, having little physical activity, failing to follow a diabetic diet, frequent inactivity, and having insufficient sleep. There were no significant differences in the physiological indicators between the depressive and nondepressive groups. After controlling for confounding factors, a logistic regression model showed that depression status was associated with a lack of sleep (OR = 2.85, p < .001), less frequent exercise (OR = 2.67, p < .001), and frequent inactivity (OR = 2.35, p = .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE This study showed that the prevalence of depression among adults with type2 DM living in rural areas is relatively high. From the perspective of health promotion, future research should focus on how to improve quality of sleep by enhancing daily physical activity and on investigating the effect of promoting a more active lifestyle among those at risk on depression.
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Proudfoot J, Clarke J, Gunn J, Fletcher S, Sanatkar S, Wilhelm K, Campbell L, Zwar N, Harris M, Lapsley H, Hadzi-Pavlovic D, Christensen H. A Web-Based Public Health Intervention to Reduce Functional Impairment and Depressive Symptoms in Adults With Type 2 Diabetes (The SpringboarD Trial): Randomized Controlled Trial Protocol. JMIR Res Protoc 2017; 6:e145. [PMID: 28778848 PMCID: PMC5561386 DOI: 10.2196/resprot.7348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 01/20/2023] Open
Abstract
Background Depressive symptoms are common in people with type 2 diabetes and contribute to adverse health consequences that substantially impact social and vocational function. Despite the existence of effective depression treatments, the majority of people with type 2 diabetes do not access these when needed. Web-based alternatives to more traditional psychotherapies offer a potential solution to reducing the personal and economic burdens of type 2 diabetes. Objective This paper outlines the protocol for a randomized controlled trial (RCT) of myCompass, a Web-based public health psychotherapy intervention, in people with type 2 diabetes. Fully automated, interactive, and delivered via the Internet without clinician support, myCompass teaches cognitive behavioral therapy-based skills and supports symptom monitoring to improve daily functioning and reduce mild-to-moderate mental health symptoms. Methods A two-arm RCT will be conducted. People with type 2 diabetes and mild-to-moderately severe depressive symptoms will be recruited from the community and general practice settings. Screening and enrollment is via an open-access website. Participants will be randomized to use either myCompass or an active placebo program for 8 weeks, followed by a 4-week tailing-off period. The placebo program is matched to myCompass on mode of delivery, interactivity, and duration. Outcomes will be assessed at baseline and at 3-month, 6-month, and 12-month follow-up. The primary study outcome is work and social functioning. Secondary study outcomes include depressive and anxious symptoms, diabetes-related distress, self-care behaviors, and glycemic control. Results Nationwide recruitment is currently underway with the aim of recruiting 600 people with type 2 diabetes. Recruitment will continue until October 2017. Conclusions This is the first known trial of a Web-based psychotherapy program that is not diabetes specific for improving social and vocational function in people with type 2 diabetes and mild-to-moderately severe depressive symptoms. With the increasing prevalence of type 2 diabetes and depression, a potentially scalable public health intervention could play a very large role in reducing unmet mental health need and ameliorating the personal and societal impact of illness comorbidity. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12615000931572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368109 (Archived by WebCite at http://www.webcitation.org/ 6rh3imVMh)
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Affiliation(s)
- Judy Proudfoot
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | | | - Jane Gunn
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Susan Fletcher
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | | | - Kay Wilhelm
- School of Psychiatry, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | - Lesley Campbell
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney, Australia
| | - Nicholas Zwar
- School of Medicine, University of Wollongong, Wollongong, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | - Helen Lapsley
- School of Psychiatry, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | - Dusan Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | - Helen Christensen
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, University of New South Wales (UNSW) Sydney, Sydney, Australia
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234
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Mitkovic Voncina M, Pejovic Milovancevic M, Mandic Maravic V, Lecic Tosevski D. Timeline of Intergenerational Child Maltreatment: the Mind-Brain-Body Interplay. Curr Psychiatry Rep 2017; 19:50. [PMID: 28664328 DOI: 10.1007/s11920-017-0805-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Still obscure mechanisms of intergenerational child maltreatment (ITCM) have been investigated partially, from various psychological and biological perspectives and from various time perspectives. This review is aimed at integrating the findings on different temporal ITCM pathways, emphasizing the mind-brain-body interplay. RECENT FINDINGS Psychological mediators of ITCM involve attachment, mentalization, dissociation, social information processing, personality traits, and psychiatric disorders. Neurobiological findings mostly refer to the neural correlates of caregiving and attachment behaviors, affected by several physiological systems (stress-response, immune, oxytocin), which also affect physical health. The latest research clusters around the epigenetic pathways of ITCM, suggesting the additional, prenatal, and preconception forms of transmission. Data suggest that ITCM needs to be conceptualized as a longitudinal process, with various interrelated psychological, neurodevelopmental, and somatic paths. Future research and prevention should take into account both, each path and each phase of ITCM, in an integrative way.
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Affiliation(s)
- Marija Mitkovic Voncina
- Institute of Mental Health, Palmoticeva 37, Belgrade, 11000, Serbia.,Belgrade University, Faculty of Medicine, Belgrade, Serbia
| | - Milica Pejovic Milovancevic
- Institute of Mental Health, Palmoticeva 37, Belgrade, 11000, Serbia.,Belgrade University, Faculty of Medicine, Belgrade, Serbia
| | | | - Dusica Lecic Tosevski
- Institute of Mental Health, Palmoticeva 37, Belgrade, 11000, Serbia. .,Belgrade University, Faculty of Medicine, Belgrade, Serbia. .,Serbian Academy of Sciences and Arts, Belgrade, Serbia.
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235
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Rebai R, Jasmin L, Boudah A. The antidepressant effect of melatonin and fluoxetine in diabetic rats is associated with a reduction of the oxidative stress in the prefrontal and hippocampal cortices. Brain Res Bull 2017; 134:142-150. [PMID: 28746841 DOI: 10.1016/j.brainresbull.2017.07.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/10/2017] [Accepted: 07/19/2017] [Indexed: 12/16/2022]
Abstract
In the past few years possible mechanisms that link diabetes and depression have been found. One of these mechanisms is the increase in lipid peroxidation and decrease in antioxidant activity in the hippocampal and prefrontal cortices, which are brain areas involved in mood. The goal of the present study was to evaluate the effect of an antidepressant and of an antioxidant on behavior and oxidative activity in brains of diabetic rats. Rats rendered diabetic after a treatment with streptozotocin (STZ) (60mg/kg) were treated with fluoxetine (15mg/kg), melatonin (10mg/kg), or vehicle for 4 weeks. All animals were tested for signs of depression and anxiety using the elevated plus maze (EPM), open field test (OFT) and the forced swim test (FST). Four groups were compared: (1) normoglycemic, (2) hyperglycemic vehicle treated, and hyperglycemic (3) fluoxetine or (4) melatonin treated rats. On the last day of the study, blood samples were obtained to determine the levels of hemoglobin A1c (HbA1c). Also, brain samples were collected to measure the oxidative stress in the hippocampal and prefrontal cortices using the thiobarbituric acid reactive substances (TBARS) assay. The activity of the antioxidant enzymes catalase (CAT), glutathione peroxidase (GPx), and glutathione S-transferase (GST) were also measured on the brain samples. The results show that both fluoxetine and melatonin decrease the signs of depression and anxiety in all tests. Concomitantly, the levels of HbA1c were reduced in drug treated rats, and to a greater degree in the fluoxetine group. In the cerebral cortex of diabetic rats, TBARS was increased, while the activity of CAT, GPx and GST were decreased. Fluoxetine and melatonin treatments decreased TBARS in both cortices. In the prefrontal cortex, fluoxetine and melatonin restored the activity of CAT, while only melatonin improved the activity of GPx and GST. In the hippocampus, the activity of GPx alone was restored by melatonin, while fluoxetine had no effect. These results suggest that antidepressants and antioxidants can counter the mood and oxidative disorders associated with diabetes. While these effects could result from a decreased production of reactive oxygen species (ROS) remains to be established.
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Affiliation(s)
- Redouane Rebai
- Department of Biochemistry & Molecular and Cellular Biology, Faculty of Natural and Life Sciences, University of Mentouri Brothers, Constantine BP, 325 Road of Ain El Bey, 25017 Constantine, Algeria.
| | - Luc Jasmin
- Department of Oral and Maxillofacial Surgery, University of California, 521 Parnassus Ave, Campus Box 0440, San Francisco, CA 94143, USA.
| | - Abdennacer Boudah
- National Higher School of Biotechnology, Ville universitaire Ali Mendjeli, BP E66 25100 Constantine, Algeria.
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236
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Persson E, Waernbaum I, Lind T. Estimating marginal causal effects in a secondary analysis of case-control data. Stat Med 2017; 36:2404-2419. [PMID: 28276084 DOI: 10.1002/sim.7277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 01/26/2017] [Accepted: 02/18/2017] [Indexed: 11/08/2022]
Abstract
When an initial case-control study is performed, data can be used in a secondary analysis to evaluate the effect of the case-defining event on later outcomes. In this paper, we study the example in which the role of the event is changed from a response variable to a treatment of interest. If the aim is to estimate marginal effects, such as average effects in the population, the sampling scheme needs to be adjusted for. We study estimators of the average effect of the treatment in a secondary analysis of matched and unmatched case-control data where the probability of being a case is known. For a general class of estimators, we show the components of the bias resulting from ignoring the sampling scheme and demonstrate a design-weighted matching estimator of the average causal effect. In simulations, the finite sample properties of the design-weighted matching estimator are studied. Using a Swedish diabetes incidence register with a matched case-control design, we study the effect of childhood onset diabetes on the use of antidepressant medication as an adult. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Emma Persson
- Department of Statistics, USBE, Umeå University, SE-90187, Umeå, Sweden
| | | | - Torbjörn Lind
- Department of Clinical Sciences, Pediatrics, Umeå University, SE-90187, Umeå, Sweden
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237
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Soufer R, Burg MM. The interface of emotion and biology in myocardial ischemia: Can we progress using the traditional paradigm? J Nucl Cardiol 2017; 24:783-787. [PMID: 28155190 DOI: 10.1007/s12350-016-0762-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/12/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Robert Soufer
- Department of Cardiology, Yale University, 950 Campbell Avenue, West Haven, CT, 06516, USA.
| | - Matthew M Burg
- Department of Cardiology, Yale University, 950 Campbell Avenue, West Haven, CT, 06516, USA
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238
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Pilot randomized controlled trial of a mindfulness-based group intervention in adolescent girls at risk for type 2 diabetes with depressive symptoms. Complement Ther Med 2017; 32:66-74. [PMID: 28619307 DOI: 10.1016/j.ctim.2017.04.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE (1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. DESIGN AND SETTING Parallel-group, randomized controlled pilot trial conducted at a university. PARTICIPANTS Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). INTERVENTIONS Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. MAIN OUTCOME MEASURES Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. RESULTS Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05). CONCLUSIONS A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. ClinicalTrials.gov identifier: NCT02218138 clinicaltrials.gov.
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239
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Chlebowy DO, Coty MB, Fu L, Hines-Martin V. Comorbid Diabetes and Depression in African Americans: Implications for the Health Care Provider. J Racial Ethn Health Disparities 2017; 5:111-116. [PMID: 28281178 DOI: 10.1007/s40615-017-0349-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 10/20/2022]
Abstract
Health care providers (HCPs) face many obstacles as they undertake efforts to meet the challenges of caring for African American patients with comorbid diabetes and depression. This review article discusses the incidence of comorbid diabetes and depression in African Americans, cultural factors affecting diabetes self-management, and clinical practice implications for the HCP. The role of patient-centered care, engagement, and best-practice strategies are discussed to provide the HCP with guidelines regarding the minimal standards that support improved health care outcomes for African Americans with comorbid diabetes and depression.
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Affiliation(s)
| | - Mary-Beth Coty
- University of Louisville School of Nursing, Louisville, KY, USA
| | - Liyan Fu
- Wenzhou Medical University School of Nursing, Wenzhou, Zhejiang, China
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240
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Mendenhall E, Kohrt BA, Norris SA, Ndetei D, Prabhakaran D. Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. Lancet 2017; 389:951-963. [PMID: 28271846 PMCID: PMC5491333 DOI: 10.1016/s0140-6736(17)30402-6] [Citation(s) in RCA: 264] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/01/2016] [Accepted: 11/30/2016] [Indexed: 12/11/2022]
Abstract
The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.
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Affiliation(s)
- Emily Mendenhall
- School of Foreign Service, Georgetown University, Washington, DC, USA.
| | - Brandon A Kohrt
- Department of Psychiatry, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Shane A Norris
- MRC Developmental Pathways for Health Research Unit, Faculty of Health, University of the Witwatersrand, Johannesburg, South Africa
| | - David Ndetei
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya; Africa Mental Health Foundation, Nairobi, Kenya
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India; London School of Hygiene & Tropical Medicine, London, UK
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241
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Scarton LJ, de Groot M. Emotional and Behavioral Aspects of Diabetes in American Indians/Alaska Natives. HEALTH EDUCATION & BEHAVIOR 2017; 44:70-82. [PMID: 27179289 DOI: 10.1177/1090198116639289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
American Indians and Alaska Natives (AI/ANs) bear a disproportionate burden of diabetes and associated long-term complications. Behavioral interventions play a vital role in promoting diabetes medical and psychological outcomes, yet the development of interventions for AI/AN communities has been limited. A systematic review was conducted of studies focused on the psychosocial and behavioral aspects of diagnosed diabetes among AI/ANs. Ovid and PubMed databases and published reference lists were searched for articles published between 1987 and 2014 that related to the psychosocial and behavioral aspects of type 1 or type 2 diabetes in the AI/AN population. Twenty studies were identified that met the inclusion criteria. Nineteen studies were observational and one study was intervention based. Two of the studies used community-based participatory research methodology. Of the 20 studies, 2 discussed cultural influences associated with diabetes self-management and 10 identified the specific tribes that participated in the study. Tribal affiliations among the studies were broad with the number of AI/AN participants in each study ranging from 30 to 23,529 participants. Emotional and behavioral topics found in the literature were adherence ( n = 2), depression ( n = 9), physical activity ( n = 3), psychosocial barriers ( n = 1), social support ( n = 3), and stress ( n = 2). Relatively few studies were identified using AI/AN populations over a 27-year period. This is in stark contrast to what is known about the prevalence and burden that type 1 and type 2 diabetes mellitus place on AI/AN communities. Future research should promote community engagement through the use of community-based participatory research methodologies, seek to further understand and describe the emotional and behavioral context for diabetes self-management in this population, and develop and test innovative interventions to promote the best possible diabetes outcomes.
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Affiliation(s)
- Lisa J Scarton
- 1 Indiana University School of Nursing, Indianapolis, IN, USA
| | - Mary de Groot
- 2 Indiana University School of Medicine, Indianapolis, IN, USA
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242
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Kreider KE. Diabetes Distress or Major Depressive Disorder? A Practical Approach to Diagnosing and Treating Psychological Comorbidities of Diabetes. Diabetes Ther 2017; 8:1-7. [PMID: 28160185 PMCID: PMC5306125 DOI: 10.1007/s13300-017-0231-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Indexed: 01/28/2023] Open
Abstract
The presence of major depressive disorder (MDD) in people with diabetes may be up to three times more common than in the general population. People with diabetes and major depressive disorder have worse health outcomes and higher mortality rates. Diabetes distress refers to an emotional state where people experience feelings such as stress, guilt, or denial that arise from living with diabetes and the burden of self-management. Diabetes distress has also been linked to worse health outcomes. There are multiple treatment options for MDD including pharmacotherapy and cognitive behavioral approaches. Providers treating patients with diabetes must be aware of the frequent comorbidity of diabetes, diabetes distress, and depression and manage patients using a multidisciplinary team approach. This article discusses the epidemiology, pathophysiology, and bi-directional relationship of diabetes and depression and provides a practical, patient-centered approach to diagnosis and management.
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Affiliation(s)
- Kathryn Evans Kreider
- Duke University School of Nursing, Durham, NC, USA.
- Duke University Medical Center, Durham, USA.
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243
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Depression can be prevented by astaxanthin through inhibition of hippocampal inflammation in diabetic mice. Brain Res 2017; 1657:262-268. [DOI: 10.1016/j.brainres.2016.12.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/28/2016] [Accepted: 12/20/2016] [Indexed: 11/22/2022]
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244
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The Use of Antidepressants, Anxiolytics, and Hypnotics in People with Type 2 Diabetes and Patterns Associated with Use: The Hoorn Diabetes Care System Cohort. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5134602. [PMID: 28232942 PMCID: PMC5292378 DOI: 10.1155/2017/5134602] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 12/27/2016] [Indexed: 01/01/2023]
Abstract
Objective. With depression being present in approximately 20% of people with type 2 diabetes mellitus (T2DM), we expect equally frequent prescription of antidepressants, anxiolytics, and hypnotics. Nevertheless, prescription data in people with T2DM is missing and the effect of depression on glycaemic control is contradictory. The aim of this study was to assess the prevalence of antidepressants, anxiolytics, and/or hypnotics use in a large, managed, primary care system cohort of people with T2DM and to determine the sociodemographic characteristics, comorbidities, T2DM medication, and metabolic control associated with its use. Method. The prevalence of antidepressants, anxiolytics, and/or hypnotics use in the years 2007-2012 was assessed in the Hoorn Diabetes Care System Cohort from the Netherlands. Results. From the 7016 people with T2DM, 500 people (7.1%) used antidepressants only, 456 people (6.5%) used anxiolytics and/or hypnotics only, and 254 people (3.6%) used a combination. Conclusion. We conclude that in our managed, primary care system 17% of all people with T2DM used antidepressants, anxiolytics, and/or hypnotics. Users of antidepressants, anxiolytics, and/or hypnotics were more often female, non-Caucasian, lower educated, and more often treated with insulin.
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245
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Kim MT, Kim KB, Ko J, Jang Y, Levine D, Lee HB. Role of depression in diabetes management in an ethnic minority population: a case of Korean Americans with type 2 diabetes. BMJ Open Diabetes Res Care 2017; 5:e000337. [PMID: 28405343 PMCID: PMC5372032 DOI: 10.1136/bmjdrc-2016-000337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/12/2017] [Accepted: 01/29/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Comorbid depression and diabetes mellitus (DM) compound challenges to disease management such as low health literacy, insufficient access to care, and social or linguistic isolation. Korean Americans (KAs), predominantly first-generation immigrants, suffer from a high prevalence of type 2 DM and depression. Limited research on KAs has prevented the development of effective interventions. OBJECTIVES To compare the prevalence of depression in KAs with DM and all Americans with/without DM, and to explore correlates of comorbid DM and depression and strategies to address KAs' DM and depression. METHODS KAs' data were from a clinical trial of a community-based self-help intervention to improve KAs' DM and mental health outcomes. National Health and Nutrition Examination Survey data sets enabled comparison. Clinical indicators included hemoglobin A1C, lipid panel, and body mass index. Psychobehavioral indicators included self-efficacy for DM management, quality of life, and depression (Patient Health Questionnaire-9 (PHQ-9)). RESULTS More KAs with DM had depression (44.2%) than did all Americans with DM (28.7%) or without DM (20.1%). Significantly more KAs with DM had mild (29.3%) or clinical (14.9%) depression than did Americans with DM (mild, 17.2%; clinical, 11.5%) or without (mild, 13.8%; clinical, 6.3%). One of six KAs with DM (16.9%) thought of suicide or self-harm (Americans with/without =5.0%, 2.8%). The self-help intervention reduced the mean PHQ-9 from 5.4 at baseline to 4.1 at 12 months. LIMITATIONS External validity might be limited; KAs' data were from one study site. CONCLUSIONS The prevalence of depression and DM among KAs warrants the development of efficacious interventions. TRIAL REGISTRATION NUMBER NCT01264796.
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Affiliation(s)
- Miyong To Kim
- School of Nursing, University of Texas at Austin,Austin, Texas, USA
| | - Kim Byeng Kim
- Korean Resource Center, Ellicott City, Maryland, USA
| | - Jisook Ko
- School of Nursing, University of Texas at Austin,Austin, Texas, USA
| | - Yuri Jang
- School of Social Work, University of Texas at Austin,Austin, Texas, USA
| | - David Levine
- School of Medicine, Johns Hopkins University,Baltimore, Maryland, USA
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Comorbidity of depression and diabetes: an application of biopsychosocial model. Int J Ment Health Syst 2016; 10:74. [PMID: 27980612 PMCID: PMC5135819 DOI: 10.1186/s13033-016-0106-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/25/2016] [Indexed: 02/06/2023] Open
Abstract
Background Type 2 diabetes (T2D) is one of the most psychologically demanding chronic medical illness in adult. Comorbidity between diabetes and depression is quite common, but most studies were based on developed country sample. Limited data exists to document biopsychosocial predictors of depressive symptoms in Ethiopian patients. Therefore, the aim of the study was to describe the association of depressive symptoms and T2D and explore the potential underlying associated biopsychosocial risk factors. Methods Institution based cross-sectional study was conducted on 276 patient with T2D at diabetic clinic, Black Lion General Specialized Hospital in Ethiopia. Patients were selected using systematic random sampling technique. Depressive symptoms score, which constructed from a validated nine-item Patient Health Questionnaire (PHQ-9), was an outcome variable. Finally, significant associated factors were identified using multiple linear regression analysis with backward elimination procedure. Statistical Package for Social Science (SPSS) version 22.0 (IBM SPSS Corp.) was used to perform all analysis. Results Total of 264 patient data was analyzed with 95.7% response rate. Patients mean (SD) current age and age at diagnosis was 55.9 (10.9) and 43.9 (10.9) years, respectively. Patients waist circumference (mean ± SD) was 98.9 ± 11.1 cm. The average PHQ-9 score was 4.9 (SD 4.1) and fasting blood glucose was 166.4 (SD 73.2). Marital status (divorced), occupation (housewife), diabetic complication (nephropathy), negative life event in the last six months, and poor social support significantly associated with increased mean PHQ-9 score after adjustment for covariates. Whereas not fearing diabetic-related complication and death significantly lower mean PHQ-9 score. Conclusion Biopsychosocial variables including marital status, negative life event in the last 6 months, occupation, diabetic complication, and poor social support significantly increase average depressive symptoms score. Evidence-based intervention focusing on these identified biopsychosocial factors are necessary to prevent the development of depressive symptoms. Electronic supplementary material The online version of this article (doi:10.1186/s13033-016-0106-2) contains supplementary material, which is available to authorized users.
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Abstract
Type 1 (T1D) and Type 2 diabetes (T2D) represent a demanding set of biopsychosocial challenges for patients and their families, whether the age of disease onset occurs in childhood, adolescence, or adulthood. Psychological conditions, defined as syndromes, disorders, and diabetes-specific psychological issues affect a larger proportion of individuals with T1D and T2D compared to the general population. In this review, we summarize the prevalence, impact and psychological treatments associated with the primary categories of psychological conditions that affect adults with T1D and T2D: depressive symptoms and syndromes, anxiety disorders, eating behaviors and disorders and serious mental illness. The implications of the literature for psychologists are discussed, and priorities for future research to advance the science of psychological conditions for adults with T1D and T2D are identified. (PsycINFO Database Record
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Affiliation(s)
| | | | - Julie Wagner
- Department of Behavioral Sciences, University of Connecticut Health Sciences Center
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Gupta S, Anderson R, Holt RI. Greater variation in affect is associated with lower fasting plasma glucose. Heliyon 2016; 2:e00160. [PMID: 27699281 PMCID: PMC5037241 DOI: 10.1016/j.heliyon.2016.e00160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/24/2016] [Accepted: 09/09/2016] [Indexed: 11/30/2022] Open
Abstract
Background Depression and bipolar illness are associated with a 2–3 fold increase in the prevalence of diabetes. However, it is unknown whether variation in mood affects glucose metabolism. The aim of this study was to assess whether changes in affect were related to fasting plasma glucose and glycated haemoglobin. Methods 379 men and 441 women who took part in the 2003 Health Survey for England and had valid data for GHQ12 and fasting blood glucose were included. Mood variability was assessed by the General Health Questionnaire 12 (GHQ12). Fasting plasma glucose and glycated haemoglobin (HbA1c) were measured by standard laboratory methodology and their relationship to variability assessed using linear regression. Results There was a significant inverse relationship between fasting blood glucose, but not HbA1c, and variability score (R2 = 0.327, p = 0.02) after adjusting for sociodemographic factors, anthropometric measurements, lifestyle, and use of medication. Conclusion This study has shown an inverse association between changes in affect and fasting plasma glucose. This unexpected finding suggests that the association between affect and glucose is more complex than previously thought. Fasting blood glucose may reflect the operation of homeostatic mechanisms that are disturbed in certain mental states and are associated, therefore, with altered risk of diabetes and related metabolic conditions. This may have implications for the management of those with such conditions and with mental disorders.
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Affiliation(s)
- Sunjai Gupta
- Institute of Psychiatry, Psychology and Neurology, Kings College, De Crespigny Park, London SE5 8AF, UK
| | | | - Richard Ig Holt
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, UK
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Diabetes and brain health: implications for practice. Ir J Psychol Med 2016; 33:179-191. [PMID: 30115190 DOI: 10.1017/ipm.2015.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is widely accepted that people with mental illness have increased risk of cardiometabolic complications such as obesity and type 2 diabetes mellitus. What is less well known is that individuals with diabetes have an increased risk of brain health complications including depression, cognitive impairment and dementia. These conditions can adversely influence disease self-management and further increase risk of other diabetes complications. Aim The aim of this paper is to highlight the increased risk of brain health complications in populations with diabetes in order to promote awareness of such complications among healthcare professionals and encourage timely intervention. METHODS An overview of the prevalence and potential mechanisms linking depression and cognitive impairment with diabetes as well as implications for detection, management and brain health protection, based on a narrative review of the literature. CONCLUSIONS Early detection and effective management of depression and cognitive impairment among individuals with diabetes has the potential to minimise adverse health outcomes. In order to promote screening healthcare professionals caring for individuals with diabetes in all settings must be aware of the increased risk of brain health complications in this vulnerable population.
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Hayley S, Audet MC, Anisman H. Inflammation and the microbiome: implications for depressive disorders. Curr Opin Pharmacol 2016; 29:42-6. [DOI: 10.1016/j.coph.2016.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/07/2016] [Indexed: 01/27/2023]
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