Skip to main content

The Role of Anxiety and Depression in Quality of Life and Symptom Reporting in People with Diabetes Mellitus

Abstract

Although quality of life evaluations are widely used throughout medicine, relatively little is known about the psychological processes involved in making these judgements. What is known is that quality of life judgements are not straightforwardly associated with objective measures of health status or clinician ratings. In particular, patient affect appears to be associated with quality of life ratings but whether this relationship is secondary to physical health or not is controversial. The aim of this study was to determine the role of anxiety and depression in the reporting of quality of life in a group of patients with diabetes mellitus. One hundred consecutive patients with diabetes (insulin-dependent diabetes mellitus n = 36 and non-insulin-dependent diabetes n = 64) were assessed using a self-report measure of quality of life, a symptom checklist and a questionnaire measure of anxiety and depression. In addition, they were independently rated for their level of physical impairment. The results showed that depression and, to a lesser extent, anxiety were significantly related to self-reported quality of life even when the differences in physical health and age were controlled for statistically. This study shows that, independent of the level of physical illness, affect, particularly depressive affect, is an important factor in the determination of quality of life.

This is a preview of subscription content, access via your institution.

References

  1. Fallowfield L. The Quality of Life: the Missing Measurement in Health Care. London: Souvenir Press, 1990.

    Google Scholar 

  2. Slevin ML, Plant H, Lynch D et al. Who should measure quality of life, the doctor or the patient? BJC, 1988; 57: 109-112.

    PubMed  CAS  Google Scholar 

  3. Wells KB, Stewart A, Hays RD et al. The functioning and well being of depressed patients; results from the Medical Outcomes Study. JAMA 1989; 262: 914-924.

    PubMed  CAS  Article  Google Scholar 

  4. Burgess AP, Dayer M, Catalan J, Hawkins DA, Gazzard B. The reliability and validity of two HIV specific health-related quality of life measures: a preliminary analysis. AIDS 1993; 7: 1001-1008.

    PubMed  CAS  Google Scholar 

  5. Hanestad BR, Albreksten G. Quality of life perceived difficulties in adherence to a diabetes regimen and blood glucose control. Diabetic Med 1991; 8: 759-764.

    PubMed  CAS  Article  Google Scholar 

  6. Lloyd CE, Mathews KA, Wing RR, Orchard TI. Psychosocial factors and complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study VIII. Diabetes Care 1992; 15: 166-172.

    PubMed  CAS  Google Scholar 

  7. Mayou R, Bryant B, Turner R. Quality of life in non-insulin dependent diabetes and comparison with insulin-dependent diabetes. JPR, 1990; 34: 1-11.

    CAS  Google Scholar 

  8. Wilkinson G, Barrey DQ, Leslie P, Newton RW, Lind C, Ballinger CB. Psychiatric morbidity and social problems in patients with insulin-dependent diabetes mellitus. BJP 1988; 153: 38-43.

    CAS  Google Scholar 

  9. Rodin G. Quality of life in adults with insulin-dependent diabetes mellitus. Psychother Psychosom 1990; 54: 132-139.

    PubMed  CAS  Article  Google Scholar 

  10. Wilson W, Biglan A, Glasgow RE et al. Psychosocial prediction of self-care, behaviour (compliance) and glycemic control in non-insulin dependent diabetes mellitus. Diabetic Care 1986; 9: 614-619.

    CAS  Google Scholar 

  11. Moses JL and Bradley C. Accuracy of subjective blood glucose estimation by patients with insulin-dependent diabetes. Bio-feedback Self-Regulat 1985; 10: 301-314.

    CAS  Article  Google Scholar 

  12. Tallroth G, Karlson B, Nillson A, Agardh CD. The influence of different insulin regimes on quality of life and metabolic control of insulin-dependent diabetics. Diabetes Res Clin Practice 1989; G(1): 37-43.

    Article  Google Scholar 

  13. Zigmund AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361-370.

    Google Scholar 

  14. Karnofsky EA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM, ed, Evaluation of Chemotherapeutic Agents, New York: Columbia University Press, 1949: 191-205.

    Google Scholar 

  15. Wu AW, Rubin HR, Mathews WC, et al. A health status questionnaire using 30 items from the medical outcomes study. Med Care 1991; 29: 786-794.

    PubMed  CAS  Google Scholar 

  16. Ader R. Psychoneuroimmunology, 2nd edn. San Diego: Academic Press Inc., 1988.

    Google Scholar 

  17. Blaney PH. Affect and memory: a review. Psychological Bulletin 1986; 99: 229-246.

    PubMed  CAS  Article  Google Scholar 

  18. Teasdale JD, Taylor R, Fogarty SJ. Effects of induced elation-depression on the accessibility of memories of happy and unhappy experiences. Behav Res Ther 1980; 18: 339-346.

    PubMed  CAS  Article  Google Scholar 

  19. Silverstone PH. Poor efficacy of the Hospital Anxiety and Depression Scale in the diagnosis of major depressive disorder in both medical and psychiatric patients. J Psychosom Res 1994; 38: 412-450.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kohen, D., Burgess, A.P., Catalán, J. et al. The Role of Anxiety and Depression in Quality of Life and Symptom Reporting in People with Diabetes Mellitus. Qual Life Res 7, 197–204 (1998). https://doi.org/10.1023/A:1024961325084

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1024961325084

  • Anxiety
  • depression
  • diabetes mellitus
  • quality of life