The course of depressive symptoms in primary care patients with type 2 diabetes: results from the Diabetes, Depression, Type D Personality Zuidoost-Brabant (DiaDDZoB) Study

• Published in: Diabetologia 2012-03, Vol.55 (3), p.608-616
• Main Authors: Nefs, G., Pouwer, F., Denollet, J., Pop, V.
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Biological and medical sciences; Chronic illnesses; Cohort Studies; Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - epidemiology; Depression - physiopathology; Diabetes; Diabetes Mellitus, Type 2 - psychology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Human Physiology; Humans; Incidence; Internal Medicine; Male; Medical Records; Medical sciences; Medicine; Medicine & Public Health; Mental depression; Metabolic Diseases; Middle Aged; Mood disorders; Netherlands - epidemiology; Personality; Prevalence; Primary care; Primary Health Care - methods; Prospective Studies; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Questionnaires; Recurrence; Risk Factors; Self Report; Sex Factors
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-011-2411-2

Aims/hypothesis The aim of the study was to examine the course (incidence, recurrence/persistence) of depressive symptoms in primary care patients with type 2 diabetes and to identify significant predictors of these different course patterns. Methods A cohort of 2,460 primary care patients with type 2 diabetes was assessed for demographic, clinical and psychological factors in 2005 and followed-up in 2007 and 2008. Depression was defined as a score of ≥12 on the Edinburgh Depression Scale. Multivariate logistic regression analyses were used to determine whether several depression-course patterns could be predicted by means of demographics, medical co-morbidities and psychological factors. Results A total of 630 patients (26%) met the criterion for depression at one or more assessments. In the subgroup with no baseline depression, incident depression at follow-up was present in 14% ( n  = 310), while recurrence/persistence in those with baseline depression was found in 66% ( n  = 212).The presence of any depression was associated with being female, low education, non-cardiovascular chronic diseases, stressful life events and a self-reported history of depression. Incident depression was predicted by female sex, low education and depression history, while patients with a history of depression had a 2.5-fold increased odds of recurrent/persistent depression. Conclusions/interpretation Depression is common in primary care patients with type 2 diabetes, with one in seven patients reporting incident depression during a 2.5 year period. Once present, depression often becomes a chronic/recurrent condition in this group. In order to identify patients who are vulnerable to depression, clinicians can use questionnaire data and/or information about the history of depression.