A cross-sectional survey of depression, anxiety, and cognitive function in patients with type 2 diabetes

Abstract

To evaluate the prevalence of depression in outpatients with type 2 diabetes and its possible correlation with anxiety, cognitive function, and clinical variables. The Zung Self-Rating Depression and Anxiety Scales and the Mini-Mental-State Examination were administered to 249 non-insulin-treated (NIT) and 249 insulin-treated (IT) outpatients with type 2 diabetes, aged 40-80, in a cross-sectional survey. Compared with a reported prevalence of 6-13% in the general population, 104 (20.9%) patients had either a score indicative of depression or were on anti-depressant medication. Assuming that medication might modify the responses to questionnaires, the latter patients were excluded from further analysis. IT patients had higher age, known duration of diabetes, HbA1c, more foot ulcers, retinopathy, microalbuminuria and practised more self-monitoring of blood glucose (P < 0.01 all) but a slightly lower mean depression score (P = 0.004) and similar anxiety or cognitive function. At multivariate analysis, depression was associated with anxiety (P < 0.001), age (P < 0.001), gender (men having lower scores than women, P = 0.042), and insulin treatment, IT patients being less depressed than NIT (P < 0.001), but none of the clinical variables. Anxiety correlated with age (P < 0.001). The association between depression and anxiety became progressively weaker with increasing age. These data confirm increased prevalence of depression in a population of patients with type 2 diabetes who did not show impaired cognitive function. The lack of correlation with disease duration, metabolic control, and complications suggests that depression may not appear/worsen with diabetes and/or its complications but rather supports suggestions that it might predate both.

Psychological distress, self-efficacy and glycemic control in type 2 diabetes

“…Nevertheless, our study showed a prevalence of depression of 18.6%, which was essentially comparable to that recently reported in a recent large meta-analysis including patients with T2D [29]. Furthermore, the prevalence of psychological symptoms herein reported was comparable to previous estimates by Trento et al in a cohort of Italian T2D patients [30]. Despite the sample size of our study was sufficiently large to detect reasonable estimates of anxiety, depression and diabetes-related distress, we recognize as a further, potential limitation that it was conducted in a single diabetes center, which might affect the generalizability of our findings.…”

Quality of life, impaired vision and social role in people with diabetes: a multicenter observational study

“…Similarly to other industrialized countries, the social security system in Italy provides free access to eye care services, such as screening, assessment and treatment for diabetic 8 retinopathy, although in many instances visits are carried out on a fee-for-service basis. However, health care systems too often underestimate the problems that may arise in the quality of life of patients (21), especially in view of the tendency of diabetes to associate with depression (22). The projected increasing prevalence of STDR and visual impairment (23) and the associated reduction in functional status and independence, will greatly increase the resulting burden of this complication of diabetes.…”

Serious Psychological Distress and Diabetes: A Review of the Literature

“…Anxiety also has been found to be associated with age among individuals with diabetes, although the association becomes weaker with increasing age [37]. In addition, anxiety has been found to be associated with lifetime severe hypoglycemia, but not abdominal obesity or cardiovascular disease, in longitudinal analysis [38].…”