Anxiety and depression in diabetes care: longitudinal associations with health-related quality of life

Abstract

Anxiety and depression are commonly found in patients with diabetes, but little is known about how the anxiety and depression symptoms of diabetes patients and the health-related quality of life (HRQoL) over time influence each other. Therefore, we conducted a survey among patients with diabetes (T1) and repeated the survey after 3 months (T2). Linear regression models and cross-lagged structural equation models were used to analyze the associations between anxiety and depression symptoms and HRQoL within and across time intervals. Correcting for baseline index and potential confounders, the HRQoL index at T2 reflected the change in anxiety/depression between T1 and T2 more than anxiety/depression at T1 (P < 0.05). Similarly, anxiety and depression at T2 reflected the change in the EQ-5D index over time more than the index at baseline (P < 0.05). Our longitudinal data fitted well in a cross-lagged model with bi-directional pathways of associations between anxiety and HRQoL, as well as depression and HRQoL, among adult patients with diabetes (x 2 /df = 1.102, P = 0.256; cfi = 1.000, RMSEA = 0.030). Our findings support early detection of anxiety and depression, as well as comprehensive efforts improving HRQoL for patients with diabetes.

Associations Between Depressive Symptoms, Anxiety Disorders, Their Comorbidity and Health-related Quality of Life: a Large-scale Cross-sectional Study

“…In this study, depressive symptoms and anxiety disorders were associated with low HRQoL. Previous study conducted in speci c population with chronic diseases have found stable associations between mental disorders and low HRQoL [12][13][14]32]. In addition, serval studies conducted in old adults also found the negative associations between mental disorders and HRQoL [33][34][35][36].…”

“…Most previous studies have focused on the effect of physical diseases on HRQoL [9][10][11], but ignored the effect of mental disorders. Previous studies have explored the association between depression, anxiety and HRQoL in speci c population [12][13][14], which indicated that depression and anxiety were negatively associated with HRQoL. However, there were few studies investigating the association in the general population, especially in rural population with limited resources.…”

The influence of hypoglycemia on the specific quality of life in type 2 diabetes mellitus: a comparative cross-sectional study of diabetics with and without hypoglycemia in Xi’an, China

“…On the other hand, doctors should strengthen the screening of anxiety and depression in diabetics [48]. Studies found that early detection of anxiety and depression can significantly improve the quality of life of diabetics [49]. Besides, for patients, proper yoga and exercise [50,51], increasing peer support and company can also alleviate depression, improve the quality of life of diabetics [52].…”

The Influence of Hypoglycemia on the Specific Quality of Life in Type 2 Diabetes Mellitus: a Comparative Cross-sectional Study of Diabetics With and Without Hypoglycemia in Xi'an, China

“…On the other hand, doctors should strengthen the screening of anxiety and depression in diabetics [46]. Studies found that early detection of anxiety and depression can signi cantly improve the quality of life of diabetics [47]. Besides, for patients, proper yoga and exercise [48,49], increasing peer support and company can also alleviate depression, improve the quality of life of diabetics [50].…”