Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study

Abstract

ObjectivesTo evaluate the prevalence and determinants of anxiety and depression and to assess their impact on glycaemic control in participants with type 2 diabetes mellitus.DesignA cross-sectional study.SettingCommunity-based investigation in Xuzhou, China.Participants893 Chinese men and women aged 18–84 years who fulfilled the inclusion criteria.MethodsPeople with type 2 diabetes completed the Pittsburgh Sleep Quality Index and the Zung Self-Rating Anxiety and Depression Scales. Demographic and physiological characteristics were recorded. Multiple logistic regression was used to evaluate the combined effect of factors associated with anxiety and depression and to assess the effects of anxiety and depression on glycaemic control.ResultsThe prevalence of depressive symptoms and anxiety symptoms was 56.1% and 43.6%, respectively. Multivariate logistic regression analysis indicated that anxiety symptoms were associated with being woman, low income, chronic disease, depressive symptoms and poor sleep quality. Depressive symptoms were associated with being woman, older age, low education level, being single, diabetes complications, anxiety symptoms and poor sleep quality. Glycaemic control was not related to anxiety symptoms (OR=1.31, 95% CIs 0.94 to 1.67) or depressive symptoms (OR=1.23, 95% CI 0.85 to 1.63). A combination of depressive symptoms and anxiety symptoms was associated with poor glycaemic control (relative excess risk due to interaction: 4.93, 95% CI 2.09 to 7.87; attributable proportion due to interaction: 0.27, 95% CI 0.12 to 0.45).ConclusionsThere was a high prevalence of depressive and anxiety symptoms in this Chinese sample of participants, although depression and anxiety were not singly associated with glycaemic control. However, a combination of depressive and anxiety symptoms was negatively correlated with glycaemic control in participants with type 2 diabetes.

Mental Disorders in Subjects with Diabetes: A Systematic Review

“…In these present exploratory results of mental disorders in subjects with diabetes about anxiety symptoms and anxiety disorders [14][15][16]18,[23][24][25][26]32], we found some relevant points. There was a high prevalence in social phobia, panic disorders or agoraphobia, psychological distress, OCD and GAD in type 1 patients with diabetes compared with type 2 [14][15][16]21,31,32].…”

“…Also, they must have frequent self-monitoring and reasonable application of injectable insulin by the glucose level may contribute to this higher prevalence of anxiety present in type 1 patients [30,31]. As the results of this study showed, both types require a warning for the treatment of that emotional disturbance [14,15,26,32]. Worry about the future is common in patients with diabetes [14][15][16]21,31,32,33].…”

“…As the results of this study showed, both types require a warning for the treatment of that emotional disturbance [14,15,26,32]. Worry about the future is common in patients with diabetes [14][15][16]21,31,32,33]. All of the time, they can get in troubles with effort, money, and stress have an emotional influence on individual stability and introduce psychiatry disorders.…”

“…There was a high prevalence in social phobia, panic disorders or agoraphobia, psychological distress, OCD and GAD in type 1 patients with diabetes compared with type 2 [14][15][16]21,31,32]. Type 1 population with diabetes appears since childhood and it possible that increase in glucose and indicated as predictive of high anxiety [18,[23][24][25][26][27][28][29][30].…”

“…Van Dooren et al [20] reported a research with 864 patients with Type 1/2 diabetes had higher levels of depressive and anxiety symptoms, odds ratios (95% CI) were 3.15 (1.49; 6.67), 1.73 (0.83-3.60), 1.50 (0.72-3.12), for PHQ-9 ≥ 10, current depressive disorder and GAD-7 ≥ 10, respectively. In the same year, Sun et al [32] studied 893 participants and found 56.1% of anxiety symptoms and 43.6% of depressive symptoms. The highest anxiety scores were more prevalent in women, with lower social status and income, chronic disease, depression and poor sleep quality.…”