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Depressive symptom trajectories in the first 10 years of diabetes diagnosis: antecedent factors and link with future disability in Taiwan

Social Psychiatry and Psychiatric Epidemiology volume 52, pages 829–836 (2017)Cite this article

A Correction to this article was published on 09 June 2018

This article has been updated

Abstract

Purpose

This study identified depressive symptom trajectories in the years after diabetes diagnosis, examined factors that predict the probability for people following a specific trajectory, and investigated how the trajectories are associated with subsequent disability.

Methods

We drew data from a nationally representative survey in Taiwan to identify adults aged 50 and older diagnosed with diabetes; 487 patients newly diagnosed with diabetes during 1996–2007 were included. Time axis was set to zero when diabetes was first reported in any given wave in the survey, and data related to depressive symptoms after that were recorded. We used group-based semi-parametric mixture models to identify trajectories of depressive symptoms and multinomial logistic regressions to examine factors associated with the trajectories.

Results

Older adults with newly diagnosis of diabetes in Taiwan follow different trajectories of depressive symptoms over time. Being female, lower educated, not married/partnered, with lower self-rated health, hospitalizations, more limitations in physical function, less regular exercise before diagnosis, and not regularly using anti-diabetic medication at the beginning of their diagnosis were factors associated with increasing or high stable depressive symptom trajectories. Those who experienced high depressive symptoms were more likely than individuals with stable depressive symptoms to have physical limitations in the last follow-up interview.

Conclusions

Depressive symptom trajectories after diabetes diagnosis were associated with select sociodemographic, health, and lifestyle factors before diagnosis, and also predicted subsequent disability. Risk groups identified in the present study may be used for personalized diabetes care that prevents diabetes-related distress and future disability.

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Fig. 1

Change history

  • 09 June 2018

    The original article can be found online at

Abbreviations

DM:

Diabetes mellitus, diabetes

References

  1. Tseng CH, Tseng CP, Chong CK, Huang TP, Song YM, Chou CW, Lai SM, Tai TY, Cheng JC (2006) Increasing incidence of diagnosed type 2 diabetes in Taiwan: analysis of data from a national cohort. Diabetologia 49:1755–1760

    Article  PubMed  Google Scholar 

  2. Chiu CJ, Wray LA, Ofstedal MB (2011) Diabetes-related change in physical disability from midlife to older adulthood: evidence from 1996–2003 Survey of Health and Living Status of the Elderly in Taiwan. Diabetes Res Clin Pract 91:413–423

    Article  PubMed  Google Scholar 

  3. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24:1069–1078

    Article  PubMed  CAS  Google Scholar 

  4. Thomasouli M-A, Brady EM, Davies MJ, Hall AP, Khunti K, Morris DH, Gray LJ (2013) The impact of diet and lifestyle management strategies for obstructive sleep apnoea in adults: a systematic review and meta-analysis of randomised controlled trials. Sleep Breath 17:925–935

    Article  PubMed  Google Scholar 

  5. De Jonge P, Roy J, Saz P, Marcos G, Lobo A (2006) Prevalent and incident depression in community-dwelling elderly persons with diabetes mellitus: results from the ZARADEMP project. Diabetologia 49:2627–2633

    Article  PubMed  Google Scholar 

  6. Egede LE, Zheng D, Simpson K (2002) Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care 25:464–470

    Article  PubMed  Google Scholar 

  7. Nouwen A, Winkley K, Twisk J, Lloyd C, Peyrot M, Ismail K, Pouwer F (2010) Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia 53:2480–2486

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Collins M, Corcoran P, Perry I (2009) Anxiety and depression symptoms in patients with diabetes. Diabet Med 26:153–161

    Article  PubMed  CAS  Google Scholar 

  9. Lipscombe C, Burns RJ, Schmitz N (2015) Exploring trajectories of diabetes distress in adults with type 2 diabetes; a latent class growth modeling approach. J Affect Disord 188:160–166

    Article  PubMed  Google Scholar 

  10. Schmitz N, Gariépy G, Smith KJ, Malla A, Wang J, Boyer R, Strychar I, Lesage A (2013) The pattern of depressive symptoms in people with type 2 diabetes: a prospective community study. J Psychosom Res 74:128–134

    Article  PubMed  Google Scholar 

  11. Nefs G, Pouwer F, Denollet J, Pop V (2012) 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. Diabetologia 55:608–616

    Article  PubMed  CAS  Google Scholar 

  12. Katon W, von Korff M, Ciechanowski P, Russo J, Lin E, Simon G, Ludman E, Walker E, Bush T, Young B (2004) Behavioral and clinical factors associated with depression among individuals with diabetes. Diabetes Care 27:914–920

    Article  PubMed  Google Scholar 

  13. Ciechanowski PS, Katon WJ, Russo JE (2000) Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med 160:3278–3285

    Article  PubMed  CAS  Google Scholar 

  14. Katon WJ, Rutter C, Simon G, Lin EH, Ludman E, Ciechanowski P, Kinder L, Young B, Von Korff M (2005) The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care 28:2668–2672

    Article  PubMed  Google Scholar 

  15. Limongi F, Noale M, Crepaldi G, Maggi S (2014) Prevalence of diabetes and depressive symptomatology and their effect on mortality risk in elderly Italians: The Italian Longitudinal Study on Aging. Diabetes Metab 40(5):373–378

    Article  PubMed  CAS  Google Scholar 

  16. Lloyd C, Dyer P, Barnett A (2000) Prevalence of symptoms of depression and anxiety in a diabetes clinic population. Diabet Med 17:198–202

    Article  PubMed  CAS  Google Scholar 

  17. Popkin MK, Callies AL, Lentz RD, Colon EA, Sutherland DE (1988) Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus. Arch Gen Psychiatry 45:64–68

    Article  PubMed  CAS  Google Scholar 

  18. Radloff L (1977) The CES-D scale. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  19. Nagi SZ (1976) An epidemiology of disability among adults in the United States. Milbank Mem Fund Q Health Soc 54:439–467

    Article  PubMed  CAS  Google Scholar 

  20. Jones BL, Nagin DS (2007) Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociol Methods Res 35:542–571

    Article  Google Scholar 

  21. Nagin DS (2005) Group-based modeling of development. Harvard University Press, Cambridge

    Book  Google Scholar 

  22. Nagin DS (1999) Analyzing developmental trajectories: a semiparametric group-based approach. Psychol Methods 4:139–157

    Article  Google Scholar 

  23. D’Unger AV, Land KC, McCall PL, Nagin DS (1998) How many latent classes of delinquent/criminal careers? results from mixed poisson regression analyses 1. Am J Sociol 103:1593–1630

    Article  Google Scholar 

  24. Khan MA, Sultan SM, Nazli R, Akhtar T, Khan MA, Sher N, Aslam H (2014) Depression among patients with type-II diabetes mellitus. J Coll Phys Surg Pak 24:770–771

    Google Scholar 

  25. Ali S, Stone M, Peters J, Davies M, Khunti K (2006) The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med 23:1165–1173

    Article  PubMed  CAS  Google Scholar 

  26. Tsai YF, Chung JW, Wong TK, Huang CM (2005) Comparison of the prevalence and risk factors for depressive symptoms among elderly nursing home residents in Taiwan and Hong Kong. Int J Geriatr Psychiatry 20:315–321

    Article  PubMed  Google Scholar 

  27. Maraldi C, Volpato S, Penninx BW, Yaffe K, Simonsick EM, Strotmeyer ES, Cesari M, Kritchevsky SB, Perry S, Ayonayon HN (2007) Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. Arch Intern Med 167:1137–1144

    Article  PubMed  Google Scholar 

  28. Ciechanowski PS, Katon WJ, Russo JE, Hirsch IB (2003) The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes. Gen Hosp Psychiatry 25:246–252

    Article  PubMed  Google Scholar 

  29. Gonzalez JS, Safren SA, Cagliero E, Wexler DJ, Delahanty L, Wittenberg E, Blais MA, Meigs JB, Grant RW (2007) Depression, self-care, and medication adherence in type 2 diabetes relationships across the full range of symptom severity. Diabetes Care 30:2222–2227

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lin EH, Katon W, Von Korff M, Rutter C, Simon GE, Oliver M, Ciechanowski P, Ludman EJ, Bush T, Young B (2004) Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care 27:2154–2160

    Article  PubMed  Google Scholar 

  31. Shaw JL, Brown J, Khan B, Mau MK, Dillard D (2013) Resources, roadblocks and turning points: a qualitative study of American Indian/Alaska native adults with type 2 diabetes. J Community Health 38:86–94

    Article  PubMed  Google Scholar 

  32. Goldman N, Lin I-F, Weinstein M, Lin Y-H (2003) Evaluating the quality of self-reports of hypertension and diabetes. J Clin Epidemiol 56:148–154

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by a Grant from the Ministry of Science and Technology (PI: Ching-Ju Chiu, MOST 102-2314-B-006-075).

Author information

Affiliations

  1. Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan

    Ching-Ju Chiu

  2. Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan

    Yu-Hsuan Tseng

  3. Department of Chinese Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, 70043, Taiwan

    Yu-Ching Hsu

  4. Department of Neurology, Kao General Hospital, Tainan, 70054, Taiwan

    Shang-Te Wu

Authors
  1. Ching-Ju Chiu
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  2. Yu-Hsuan Tseng
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  3. Yu-Ching Hsu
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Correspondence to Ching-Ju Chiu.

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Chiu, CJ., Tseng, YH., Hsu, YC. et al. Depressive symptom trajectories in the first 10 years of diabetes diagnosis: antecedent factors and link with future disability in Taiwan. Soc Psychiatry Psychiatr Epidemiol 52, 829–836 (2017). https://doi.org/10.1007/s00127-016-1314-4

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  • DOI: https://doi.org/10.1007/s00127-016-1314-4

Keywords

  • Diabetes
  • Depressive symptoms
  • Long-term trajectories
  • Middle-aged and older adults