The course of depressive symptoms in primary care patients with type 2 diabetes: results from the Diabetes, Depression, Type D Personality Zuidoost-Brabant (DiaDDZoB) Study

G Nefs, F Pouwer, J Denollet, V Pop, G Nefs, F Pouwer, J Denollet, V Pop

Abstract

Aims/hypothesis: The aim of the study was to examine the course (incidence, recurrence/persistence) of depressive symptoms in primary care patients with type 2 diabetes and to identify significant predictors of these different course patterns.

Methods: A cohort of 2,460 primary care patients with type 2 diabetes was assessed for demographic, clinical and psychological factors in 2005 and followed-up in 2007 and 2008. Depression was defined as a score of ≥ 12 on the Edinburgh Depression Scale. Multivariate logistic regression analyses were used to determine whether several depression-course patterns could be predicted by means of demographics, medical co-morbidities and psychological factors.

Results: A total of 630 patients (26%) met the criterion for depression at one or more assessments. In the subgroup with no baseline depression, incident depression at follow-up was present in 14% (n = 310), while recurrence/persistence in those with baseline depression was found in 66% (n = 212).The presence of any depression was associated with being female, low education, non-cardiovascular chronic diseases, stressful life events and a self-reported history of depression. Incident depression was predicted by female sex, low education and depression history, while patients with a history of depression had a 2.5-fold increased odds of recurrent/persistent depression.

Conclusions/interpretation: Depression is common in primary care patients with type 2 diabetes, with one in seven patients reporting incident depression during a 2.5 year period. Once present, depression often becomes a chronic/recurrent condition in this group. In order to identify patients who are vulnerable to depression, clinicians can use questionnaire data and/or information about the history of depression.

Figures

Fig. 1
Fig. 1
Prevalence of depression (EDS score ≥ 12) at baseline (M0) and the two follow-up assessments (M1, M2) for the total sample (n = 2,460) and examined separately for men (n = 1,192) and women (n = 1,268). Bars represent total group (black), men (dark grey) and women (light grey); the number shown above each bar represents the number with depression in that group. p < 0.001 for men vs women for all three assessments

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Source: PubMed

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