Depression treatment and health-related quality of life among adults with diabetes and depression

Abstract

Background Previous findings regarding depression treatment and its consequences on health-related quality of life (HRQoL) of adults with diabetes were inconsistent and targeted certain groups of population. Therefore, there is a critical need to conduct a population-based study that focuses on a general population with diabetes and depression. Objective The primary aim of this study was to examine the physical and mental HRQoL associated with depression treatment during the follow-up year. Methods We adopted a longitudinal design using multiple panels (2005–2011) of the Medical Expenditure Panel Survey to create a baseline year and follow-up year. We included adults with diabetes and depression. We categorized the baseline depression treatment into: (1) antidepressant use only; (2) psychotherapy with or without antidepressants; and (3) no treatment. HRQOL was measured using SF-12 version 2 physical component summary (PCS) and SF-12 mental component summary (MCS) scores during both baseline year and follow-up year. Ordinary least squares (OLS) were used to estimate the association between depression treatment and the HRQoL measures. The OLS regression controlled for predisposing, enabling, need, external environment factors, personal health practices, and baseline HRQoL measures. Results After controlling for all the independent variables and the baseline PCS, individuals who received psychotherapy with or without antidepressants had higher PCS scores as compared to those without any treatment for depression (beta = 1.28, p < 0.001). Individuals who reported using only antidepressants had lower PCS scores (beta = −0.54, p < 0.001) as compared to those without depression treatment. On the contrary, individuals who reported receiving psychotherapy with or without antidepressants had lower MCS scores as compared to those without depression treatment (beta = −1.43, p < 0.001). Those using only antidepressants had higher MCS scores as compared to those without depression treatment (beta =0.56, p < 0.001). Conclusion The associations between depression treatment and the HRQoL varied by the type of depression treatment and the component of the HRQoL measures.

Variability in sleep disturbance, physical activity and quality of life by level of depressive symptoms in women with Type 2 diabetes

“…In both non‐depressed and depressed women with Type 2 diabetes, the association between antidepressant use and physical health‐related quality of life was negative, although it was more strongly negative among the non‐depressed. This is consistent with prior longitudinal research in adults with comorbid depression and diabetes . Thus, evidence is growing that antidepressant use is associated with poorer physical health‐related quality of life among adults with diabetes, despite recent reviews that identified improved glycaemic control in trials of antidepressants among adults with comorbid depression and diabetes .…”

“…While these cross‐sectional analyses do not establish causality, our findings support previous research suggesting that addressing depression in women with diabetes may improve other health‐related outcomes. Longitudinal, population‐based research suggests that US adults with comorbid diabetes and depression who receive psychotherapy have greater quality of life than those receiving no treatment for depression , but intervention trials in adults with diabetes have not focused on sleep outcomes. A recent meta‐analysis demonstrated that cognitive behavioural therapy, in particular, improves depression, quality of life, and fasting glucose among adults with comorbid depression and diabetes ; however, compared with pharmacological treatment for depression in adults with diabetes, use of psychological services is low (~15%) .…”

“…Adults with diabetes, particularly older adults, tend to receive pharmacological treatment for depression , but the results are mixed. Although antidepressant use can improve glycaemic control in adults with comorbid depression and diabetes , it also is associated with poorer physical health‐related quality of life ; therefore, the effects of antidepressant use among adults with diabetes require further study .…”

Implementing and feasibility testing depression screening using the electronic medical record for patients with type 2 diabetes admitted to the hospital

“…Moreover, the improvement in MCS scores exceeded the improvement in PCS scores. Similarly, a recent Medical Expenditure Panel Survey analysis (Alenzi & Sambamoorthi, ) among patients with diabetes and depression also reported improvement in MCS scores, but not in PCS scores, when their depression was managed by antidepressants alone.…”

Health related quality of life and healthcare utilization among adults with diabetes and kidney and eye complications in the United States

“…Based on this model, health outcomes and healthcare use may be influenced by predisposing factors (e.g., age and sex), enabling factors (e.g., education level and health insurance), need factors (e.g., physical and mental health) and personal health practices (e.g., smoking status). Also, previously conducted studies have shown that demographics, socioeconomic status, health insurance and comorbid conditions are associated with HRQoL [32,33]. Other explanatory variables include sex (female, male); age (21-39, 40-49, 50-64 and 65 years or older); race/ethnicity (White, African American, Latino, and other); marital status (married, separated/divorced, widowed and never married); poverty status: poor (less than 100% federal poverty line), near poor (100% to less than 200%), middle income (200% to less than 400%), and high income (greater than or equal to 400%); health insurance coverage (private, public, uninsured); prescription drug coverage (yes or no); presence of other cooccurring physical conditions (asthma, arthritis, cancer, gastroesophageal reflux disease (GERD), heart diseases, hypertension, osteoporosis, thyroid, and chronic obstructive pulmonary disease (COPD)); smoking status (current smoker and others); Body Mass Index (BMI) categories (underweight/normal (≤24.9), overweight (25-29.9), obese (≥ 30)); and physical activity (vigorous or moderate activities at least 3 days a week and other).…”