The differential associations of depression and diabetes distress with quality of life domains in type 2 diabetes
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The present investigation aimed to understand quality of life domains relevant to adults with type 2 diabetes mellitus (T2DM), and the relative associations of depression and diabetes distress with these domains. Participants were 146 individuals with T2DM who were recruited for entry into a randomized controlled trial of cognitive behavioral therapy for adherence and depression. We conducted an exploratory factor analysis on the Quality of Life Inventory (QOLI) to establish domains of quality of life relevant to this patient population. Hierarchical multiple regression models were evaluated for each domain that emerged to determine independent associations of depression severity and diabetes distress with quality of life independent of demographic and illness factors. Results suggested four quality of life domains: achievement, psychosocial growth, interpersonal relationships, and environment, accounting for 60.1 % of variance in total QOLI scores. Depression severity was associated with poorer quality of life on the achievement, psychosocial growth, and environment domains (p’s < 0.01), while diabetes distress was associated with poorer quality of life on the achievement (p < 0.001) domain and marginally associated with quality of life on the psychosocial growth (p < 0.10) domain. Interventions designed to address both depression and diabetes distress may lead to better quality of life outcomes than a generalized depression intervention or an intervention for diabetes alone.
KeywordsDiabetes T2DM Quality of life QOLI Depression Diabetes distress
The project described was supported by Award Number R01MH078571 to Dr. Steven A. Safren from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. This research was also conducted with support from the Investigator-Initiated Study Program of LifeScan, Inc in the form of donated glucometers and glucose test strips. This work was also conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (NIH Award #UL1 RR 025758 and financial contributions from Harvard University and its affiliated academic health care centers). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, the National Center for Research Resources, or the National Institutes of Health. JSG is also supported in part by award number NIDDK DK 020541 from the National Institute of Diabetes and Digestive and Kidney Diseases.
- Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., et al. (2004). Disability and quality of life impact of mental disorders in Europe: Results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109, 38–46.CrossRefGoogle Scholar
- Bartlett, J. E., Kotrlik, J. W., & Higgins, C. C. (2001). Organizational research: Determining appropriate sample size in survey research. Information Technology, Learning and Performance, 19, 43–50.Google Scholar
- Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row.Google Scholar
- Fisher, L., Mullan, J. T., Arean, P., Glasgow, R. E., Hessler, D., & Masharani, U. (2010). Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care, 33, 23–28.PubMedCentralPubMedCrossRefGoogle Scholar
- Frisch, M. B. (1994). Quality of life inventory: Manual and treatment guide. Minneapolis, MN: NCS Pearson.Google Scholar
- Gorusch, R. L. (1983). Factor analysis (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
- Safren, S. A., Gonzalez, J. S., & Soroudi, N. (2007). Coping with chronic illness: A cognitive behavioral therapy approach for adherence and depression: Therapist guide. New York: Oxford University Press.Google Scholar
- Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The mini-international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMedGoogle Scholar