As Time Goes by: Anxiety Negatively Affects the Perceived Quality of Life in Patients With Type 2 Diabetes of Long Duration

Abstract

Introduction Age-related medical conditions are increasing worldwide. Type 2 Diabetes mellitus (T2DM) represents a chronic disease, which affects a large amount of general population, accounting for over 90% of diabetes mellitus (DM) cases. Purpose As psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL). Methods Forty five patients with T2DM were consecutively recruited and assessed with a psychodiagnostic battery: Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory II edition (BDI-II) and the 36-Item Short Form Health Survey (SF-36), including indexes Physical and Mental Component Summary (PCS, MCS). Moreover, time since DM diagnosis and glycated hemoglobin (HbA1c) values were detected. Results Participants (mean age 65.3 ± 5.9 years) had a mean time since diagnosis of 11.6 ± 6.7 years, and showed a good metabolic control as highlighted by mean HbA1c values 7.1 ± 0.9%. Median HAM-A score [25(20.7–30.6)], represented high prevalence of anxious symptoms. A moderate expression of depressive symptoms was observed [BDI-II score: 13(8.3–21.4)]. A multiple regression analysis, after correcting for age, BMI, HbA1c value and BDI-II score, showed the perceived quality of life relative to PCS was significantly related to both disease duration (β = −0.55, p = 0.03, SE = 0.25) and HAM-A scores (β = −0.52, p = 0.04, SE = 0.24). Moreover, both HAM-A (β = −0.67, p = 0.01, SE = 0.26) and BDI-II (β = −0.48, p = 0.02, SE = 0.20) scores were independently predictive of MCS. Metabolic control, instead, was not a significant predictor. Conclusion Our study suggests a predictive role of both anxiety levels and time since diagnosis in perceived HRQoL in T2DM patients. PCS was associated with anxiety and time since diagnosis and MCS was associated with anxiety and depressive symptoms but not with diabetes duration or metabolic control. These data could be useful to plan T2DM training programs focused on psychological health concerns, possibly leading to a healthy self-management and a better perceived HRQoL, even assisting patients in reducing the negative effect due to the chronicization of T2DM.

Depression, anxiety, and associated factors in patients with diabetes: evidence from the Anxiety, Depression, and Personality Traits in Diabetes Mellitus (ADAPT-DM) study

“…However, higher psychological QOL reduced the odds of anxiety disorders in diabetic patients, which is in line with the findings of other studies on patients with diabetes [33,34]. As expected, conscientiousness is inversely related to anxiety disorders, such as generalized anxiety disorder, panic disorder, agoraphobia, and social phobia [35].…”

Depression, anxiety, and associated factors in patients with diabetes: evidence from the Anxiety, Depression, and Personality Traits in Diabetes Mellitus (ADAPT-DM) study

“…This is contradictory to previous findings which suggest anxiety is inversely correlated with all the components of QOL [31]. However, higher psychological QOL reduced the odds of anxiety disorders in diabetic patients, which is in line with the findings of other studies on patients with diabetes [31,32].…”

Quality of life and psychological functioning in postmenopausal women undergoing aromatase inhibitor treatment for early breast cancer

“…AIs treatment has been associated with adverse events such as increased bone loss, musculoskeletal pain, impaired lipid profile and cardiovascular risk, but also with mood disturbances, anxiety and memory deficit [6][7][8]. Physical and psychological side effects seriously impair women's psychological balance and perceived QoL and may negatively influence the participation in medical care and adherence to every fundamental prescription [9][10][11][12][13][14][15][16][17]. In fact, several studies demonstrate the importance played by traumatic factors both on mental health and mood which could also lead to an increased suicidal risk and cognitive decline [18][19][20][21][22][23][24].…”