Skip to main content
SpringerLink
Log in

Depressive symptoms and clustering of cardiovascular disease risk factors in diabetes patients

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Depressive symptoms may be related to the development of coronary heart disease (CHD) in patients with diabetes mellitus. The objective of the present study was to investigate the relationship between cardiovascular disease risk factors and depressive symptoms in patients with type 2 diabetes. A total of 179 patients with type 2 diabetes completed a questionnaire and gave a blood sample. The questionnaire consisted of demographics, the medication adherence questionnaire, the summary of diabetes self-care activities questionnaire, and the Beck Depression Inventory II questionnaire. Blood samples were analyzed for glucose and lipid profile. Elevated depression Beck score had a significant relation with female gender, numbness or pain in peripheries, younger age group ≤50 years, and elevated triglycerides (TG). Diabetes complications also had a significant relation with depression and more specifically with performance impairment and depression-nonspecific items. A significant relation was found between uncontrolled diabetes and somatic disturbance. Under-adherence to medications was significantly related to depression-specific items. Obesity was significantly related to depression-nonspecific items. Several factors are correlated with depression symptoms in diabetes patients. Additionally, control of somatic disturbance and performance impairment of depression should be regarded as important components of appropriate diabetes care to ensure diabetes control and medication adherence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lam DW, LeRoith D. The worldwide diabetes epidemic. Curr Opin Endocrinol Diabetes Obes. 2012;19(2):93–6. doi:10.1097/MED.0b013e328350583a.

    Article  PubMed  Google Scholar 

  2. Kesteloot H. On the relative importance of cardiovascular disease and cancer as causes of death: the effect of age and sex. Acta Cardiol. 2008;63(3):293–5.

    Article  PubMed  Google Scholar 

  3. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.

    Article  PubMed  Google Scholar 

  4. Bonow RO, Smaha LA, Smith Jr SC, Mensah GA, Lenfant C. World Heart Day 2002: the international burden of cardiovascular disease: responding to the emerging global epidemic. Circulation. 2002;106(13):1602–5.

    Article  PubMed  Google Scholar 

  5. Preis SR, Pencina MJ, Hwang SJ, D'Agostino Sr RB, Savage PJ, Levy D, et al. Trends in cardiovascular disease risk factors in individuals with and without diabetes mellitus in the Framingham Heart Study. Circulation. 2009;120(3):212–20. doi:10.1161/CIRCULATIONAHA.108.846519.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Fox CS. Cardiovascular disease risk factors, type 2 diabetes mellitus, and the Framingham Heart Study. Trends Cardiovasc Med. 2010;20(3):90–5. doi:10.1016/j.tcm.2010.08.001.

    Article  PubMed Central  PubMed  Google Scholar 

  7. deGoma EM, Knowles JW, Angeli F, Budoff MJ, Rader DJ. The evolution and refinement of traditional risk factors for cardiovascular disease. Cardiol Rev. 2012;20(3):118–29. doi:10.1097/CRD.0b013e318239b924.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Joynt KE, Whellan DJ, O’Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry. 2003;54(3):248–61.

    Article  PubMed  Google Scholar 

  9. Katon WJ, Lin EH, Russo J, Von Korff M, Ciechanowski P, Simon G, et al. Cardiac risk factors in patients with diabetes mellitus and major depression. J Gen Intern Med. 2004;19(12):1192–9. doi:10.1111/j.1525-1497.2004.30405.x.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Lichtman JH, Bigger Jr JT, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lesperance F, et al. Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation. 2008;118(17):1768–75. doi:10.1161/CIRCULATIONAHA.108.190769.

    Article  PubMed  Google Scholar 

  11. Paile-Hyvarinen M, Raikkonen K, Forsen T, Kajantie E, Yliharsila H, Salonen MK, et al. Depression and its association with diabetes, cardiovascular disease, and birth weight. Ann Med. 2007;39(8):634–40. doi:10.1080/07853890701545722.

    Article  PubMed  Google Scholar 

  12. Labad J, Price JF, Strachan MW, Fowkes FG, Ding J, Deary IJ, et al. Symptoms of depression but not anxiety are associated with central obesity and cardiovascular disease in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetologia. 2010;53(3):467–71. doi:10.1007/s00125-009-1628-9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Rubin RR, Gaussoin SA, Peyrot M, DiLillo V, Miller K, Wadden TA, et al. Cardiovascular disease risk factors, depression symptoms and antidepressant medicine use in the Look AHEAD (Action for Health in Diabetes) clinical trial of weight loss in diabetes. Diabetologia. 2010;53(8):1581–9. doi:10.1007/s00125-010-1765-1.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Nichols GA, Moler EJ. Cardiovascular disease, heart failure, chronic kidney disease and depression independently increase the risk of incident diabetes. Diabetologia. 2011;54(3):523–6. doi:10.1007/s00125-010-1965-8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Huang CY, Chi SC, Sousa VD, Wang CP, Pan KC. Depression, coronary artery disease, type 2 diabetes, metabolic syndrome and quality of life in Taiwanese adults from a cardiovascular department of a major hospital in Southern Taiwan. J Clin Nurs. 2011;20(9-10):1293–302. doi:10.1111/j.1365-2702.2010.03451.x.

    Article  PubMed  Google Scholar 

  16. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-421.

  17. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67–74.

    Article  CAS  PubMed  Google Scholar 

  18. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23(7):943–50.

    Article  CAS  PubMed  Google Scholar 

  19. Lustman PJ, Clouse RE, Griffith LS, Carney RM, Freedland KE. Screening for depression in diabetes using the Beck Depression Inventory. Psychosom Med. 1997;59(1):24–31.

    Article  CAS  PubMed  Google Scholar 

  20. Uslu RI, Kapci EG, Oncu B, Ugurlu M, Turkcapar H. Psychometric properties and cut-off scores of the Beck Depression Inventory-II in Turkish adolescents. J Clin Psychol Med Settings. 2008;15(3):225–33. doi:10.1007/s10880-008-9122-y.

    Article  PubMed  Google Scholar 

  21. Byrne BM. Factor analytic models: viewing the structure of an assessment instrument from three perspectives. J Pers Assess. 2005;85(1):17–32. doi:10.1207/s15327752jpa8501_02.

    Article  PubMed  Google Scholar 

  22. Morley S, Williams AC, Black S. A confirmatory factor analysis of the Beck Depression Inventory in chronic pain. Pain. 2002;99(1-2):289–98.

    Article  PubMed  Google Scholar 

  23. Wang YP, Lederman LP, Andrade LH, Gorenstein C. Symptomatic expression of depression among Jewish adolescents: effects of gender and age. Soc Psychiatry Psychiatr Epidemiol. 2008;43(1):79–86. doi:10.1007/s00127-007-0270-4.

    Article  PubMed  Google Scholar 

  24. Gorenstein C, Andrade L, Zanolo E, Artes R. Expression of depressive symptoms in a nonclinical Brazilian adolescent sample. Can J Psychiatry. 2005;50(3):129–36.

    PubMed  Google Scholar 

  25. Wang YP, Andrade LH, Gorenstein C. Validation of the Beck Depression Inventory for a Portuguese-speaking Chinese community in Brazil. Braz J Med Biol Res. 2005;38(3):399–408. doi:10.1590/S0100-879X2005000300011.

    Article  PubMed  Google Scholar 

  26. Grundy SM. Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab. 2004;89(6):2595–600. doi:10.1210/jc.2004-0372.

    Article  CAS  PubMed  Google Scholar 

  27. Lee HJ, Chapa D, Kao CW, Jones D, Kapustin J, Smith J, et al. Depression, quality of life, and glycemic control in individuals with type 2 diabetes. J Am Acad Nurse Pract. 2009;21(4):214–24. doi:10.1111/j.1745-7599.2009.00396.x.

    Article  PubMed  Google Scholar 

  28. Odegard PS, Capoccia K. Medication taking and diabetes: a systematic review of the literature. Diabetes Educ. 2007;33(6):1014–29. doi:10.1177/0145721707308407. discussion 30-1.

    Article  PubMed  Google Scholar 

  29. Katon WJ, Russo JE, Heckbert SR, Lin EH, Ciechanowski P, Ludman E, et al. The relationship between changes in depression symptoms and changes in health risk behaviors in patients with diabetes. Int J Geriatr Psychiatry. 2010;25(5):466–75. doi:10.1002/gps.2363.

    Article  PubMed  Google Scholar 

  30. Gonzalez JS, Safren SA, Delahanty LM, Cagliero E, Wexler DJ, Meigs JB, et al. Symptoms of depression prospectively predict poorer self-care in patients with Type 2 diabetes. Diabet Med. 2008;25(9):1102–7. doi:10.1111/j.1464-5491.2008.02535.x.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Shehatah A, Rabie MA, Al-Shahry A. Prevalence and correlates of depressive disorders in elderly with type 2 diabetes in primary health care settings. J Affect Disord. 2010;123(1-3):197–201. doi:10.1016/j.jad.2009.09.002.

    Article  PubMed  Google Scholar 

  32. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001;63(4):619–30.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by Jordan University of Science and Technology.

Conflict of interest

None to declare

Author information

Authors and Affiliations

  1. Department of Public Health, Community Medicine and Family Medicine, Jordan University of Science and Technology, Irbid, Jordan

    Reema A. Karasneh & Yousef S. Khader

  2. Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan

    Sayer I. Al-Azzam & Karem H. Alzoubi

  3. Department of Pharmacy, Royal Medical Services, Amman, Jordan

    Jaafar A. Abu Abeeleh

Authors
  1. Reema A. Karasneh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sayer I. Al-Azzam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karem H. Alzoubi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jaafar A. Abu Abeeleh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yousef S. Khader
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reema A. Karasneh.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karasneh, R.A., Al-Azzam, S.I., Alzoubi, K.H. et al. Depressive symptoms and clustering of cardiovascular disease risk factors in diabetes patients. Int J Diabetes Dev Ctries 35 (Suppl 2), 240–247 (2015). https://doi.org/10.1007/s13410-015-0382-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-015-0382-4

Keywords

Search

Navigation