The Relationship Between the Severity of Depressive Symptoms and Diabetes-Related Emotional Distress in Patients with Type 2 Diabetes

OBJECTIVE: To examine the relationship between the severity of depressive symptoms and the burden through diabetes care, or diagnosed diabetes in patients with type 2 diabetes, irrespective of the diabetic complications and glycemic control. PATIENTS AND METHODS: Subjects were 126 outpatients with type 2 diabetes who completed the Beck Depression Inventory-II (BDI-II), Problem Areas in Diabetes (PAID) scale, and Short Form-36 (SF-36). RESULTS: The factor with a significant impact on the BDI-II score in the multiple regression model was the PAID score (standardized coefficient =0.17, 95% confidence interval CI, 0.12-0.21). The factors having a significant impact on the physical component summary of SF-36 (PCS) in the multiple regression model were BDI-II score (-0.95; 95% CI, -1.32 - -0.58), age (-0.43; 95% CI, -0.61 - -0.25), and the number of complicated macroangiopathies (-8.90; 95% CI, -12.71 - -5.08). The factors with a significant impact on the mental component summary of SF-36 (MCS) in the multiple regression model were BDI-II score (-0.90; 95% CI, -1.16 - -0.65) and age (0.13; 95% CI, 0.00-0.25). CONCLUSION: These findings show that diabetes-related emotional distress is significantly related to the severity of depressive symptoms in patients with type 2 diabetes, independent of the severity of complications and glycemic control. Moreover, the severity of depressive symptoms is negatively correlated with comprehensive health-related QOL in patients with type 2 diabetes. Clinicians need to consider factors other than indices of metabolic control and diabetic complications, in determining the adverse effects of depressive symptoms on the physical QOL of patients with type 2 diabetes.