Skip to main content

Advertisement

SpringerLink
Log in

Differences in the cluster of depressive symptoms between subjects with type 2 diabetes and individuals with a major depressive disorder and without diabetes

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Background

Depressive disorder encompasses a wide spectrum of somatic and psychological symptoms. It is not known whether there are differences regarding the cluster of depressive symptomatology between subjects with depression with and without T2DM.

Purpose

To explore whether the cluster of depression that prevails among depressive subjects with T2DM differs from individuals with depression, but without T2DM.

Methods

87 T2DM patients with a pathological Beck Depression Inventory test (BDI) were compared with 50 age- and gender-matched individuals with a major depressive disorder. All 21 items expressed in the BDI were compared between the two groups.

Results

The score obtained after administering the BDI was comparable between patients with T2DM and significant depressive symptoms and the control group (18.8 ± 2.7 vs 18.9 ± 3.4; p = 0.9). Subjects with T2DM had higher scores compared with the control group in the following items: sadness (1.4 ± 0.9 vs 0.9 ± 0.9; p = 0.011), difficulty in concentration (1.3 ± 0.8 vs 0.8 ± 0.8; p = 0.01), indecisiveness (1.1 ± 0.8 vs 0.5 ± 0.9; p = 0.012), worries about their health (1.3 ± 0.9 vs 0.6 ± 0.9; p < 0.0001), fatigue (1.2 ± 0.6 vs 0.8 ± 0.7; p = 0.003) and loss of sexual appetite (2.7 ± 0.6 vs 1.2 ± 1.3; p = 0.0001). Suicidal ideation was significantly lower among subjects with T2DM compared with the control group (0.1 ± 0.3 vs 0.6 ± 0.8; p = 0.0001).

Conclusions

Subjects with T2DM and a positive screening for depression presented a different cluster of depression compared with depressed subjects without T2DM, with a predominance of somatic–biological depressive symptoms rather than psychological–cognitive cluster and negative emotions, such as suicidal ideation.

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

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. World Health Organization (2005) Revised global burden of disease (GBD) 2002 estimates. http://www.who.int/healthinfo/global_burden_disease/en/index.html. Accessed 18 Feb 2019

  2. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B (2007) Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 370:851–858

    Article  PubMed  Google Scholar 

  3. Roy T, Lloyd CE (2012) Epidemiology of depression and diabetes: a systematic review. J Affect Disord 142(Suppl):S8–S21

    Article  PubMed  Google Scholar 

  4. Pouwer F, Geelhoed-Duijvestijn PH, Tack CJ et al (2010) Prevalence of comorbid depression is high in out-patients with type 1 or type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands. Diabet Med 27:217–224

    Article  CAS  PubMed  Google Scholar 

  5. Li C, Ford ES, Strine TW et al (2008) Prevalence of depression among US adults with diabetes: findings from the 2006 behavioural risk factor surveillance system. Diabetes Care 31:105–107

    Article  PubMed  Google Scholar 

  6. Lloyd CE, Roy T, Nouwen A et al (2012) Epidemiology of depression in diabetes: international and cross-cultural issues. J Affect Disord 142(Suppl):S22–S29

    Article  PubMed  Google Scholar 

  7. Castro-Costa E, Dewey M, Stewart R et al (2007) Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study. Br J Psychiatry 191:393–401

    Article  CAS  PubMed  Google Scholar 

  8. Copeland JR, Beekman AT, Braam AW et al (2004) Depression among older people in Europe: the EURODEP studies. World Psychiatry 3:45–49

    PubMed  PubMed Central  Google Scholar 

  9. Nicolau J, Simó R, Sanchís P, Ayala L, Fortuny R, Rivera R, Masmiquel L (2016) Prevalence and clínical correlators of undiagnosed significant depressive symptoms among individuals with type 2 diabetes in a Mediterranean population. Exp Clin Endocrinol Diabetes 124:1–7

    Article  CAS  Google Scholar 

  10. Finkelstein EA, Bray JW, Chen H et al (2003) Prevalence and costs of major depression among elderly claimants with diabetes. Diabetes Care 26:415–420

    Article  PubMed  Google Scholar 

  11. 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 

  12. de Groot M, Anderson R, Freedland KE et al (2001) Association of depression and diabetes complications: a meta-analysis. Psychosom Med 63:619–630

    Article  PubMed  Google Scholar 

  13. Katon WJ, Young BA, Russo J et al (2013) Association of depression with increased risk of severe hypoglycaemic episodes in patients with diabetes. Ann Fam Med 11:245–250

    Article  PubMed  PubMed Central  Google Scholar 

  14. Duru NS, Civilibal M, Elevli M (2016) Quality of life and psychological screening in children with type 1 diabetes and their mothers. Exp Clin Endocrinol Diabetes 124:105–110

    CAS  PubMed  Google Scholar 

  15. Richardson LK, Egede LE, Mueller M et al (2008) Longitudinal effects of depression on glycemic control in veterans with type 2 diabetes. Gen Hosp Psychiatry 30:509–514

    Article  PubMed  Google Scholar 

  16. Aikens JE, Perkins DW, Lipton B et al (2009) Longitudinal analysis of depressive symptoms and glycemic control in type 2 diabetes. Diabetes Care 32:1177–1181

    Article  PubMed  PubMed Central  Google Scholar 

  17. de Groot M, Jacobson AM, Samson JA et al (1999) Glycemic control and major depression in patients with type 1 and type 2 diabetes mellitus. J Psychosom Res 46:425–435

    Article  PubMed  Google Scholar 

  18. Lustman PJ, Clouse RE, Nix BD et al (2006) Sertraline for prevention of depression recurrence in diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Arch Gen Psychiatry 63:521–529

    Article  PubMed  Google Scholar 

  19. Lustman PJ, Freedland KE, Griffith LS et al (2000) Fluoxetine for depression in diabetes: a randomized double-blind placebo-controlled trial. Diabetes Care 23:618–623

    Article  CAS  PubMed  Google Scholar 

  20. Amsterdam JD, Shults J, Rutherford N et al (2006) Safety and efficacy of s-citalopram in patients with co-morbid major depression and diabetes mellitus. Neuropsychobiology 54:208–214

    Article  CAS  PubMed  Google Scholar 

  21. Paile-Hyvaärinen M, Wahlbeck K, Eriksson JG (2007) Quality of life and metabolic status in mildly depressed patients with type 2 diabetes treated with paroxetine: a double-blind randomised placebo controlled 6-month trial. BMC Fam Pract 8:34–37

    Article  CAS  Google Scholar 

  22. Ghaeli P, Shahsavand E, Mesbahi M et al (2004) Comparing the effects of 8-week treatment with fluoxetine and imipramine on fasting blood glucose of patients with major depressive disorder. Clin Psychopharmacol 24:386–388

    Article  CAS  Google Scholar 

  23. Nicolau J, Rivera R, Francés C et al (2013) Treatment of depression in type 2 diabetic patients: effects on depressive symptoms, quality of life and metabolic control. Diabetes Res Clin Pract 101:148–152

    Article  CAS  PubMed  Google Scholar 

  24. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders DSM-V, 5th edn. American Psychiatric Publishing, Arlington

    Book  Google Scholar 

  25. Lux V, Kendler KS (2010) Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria. Psychol Med 40:1679–1690

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. de Jonge P (2011) Depression deconstruction lessons from psychosomatic research. J Psychosom Res 71:59–60

    Article  PubMed  Google Scholar 

  27. Beck AT, Steer RA, Brown GA (1996) Beck Depression Inventory-II (BDI-II). Manual. Pearson, Oxford

    Google Scholar 

  28. Lustman PJ, Clouse RE, Griffith LS et al (1997) Screening for depression in diabetes using the Beck Depression Inventory. Psychosom Med 59:24–31

    Article  CAS  PubMed  Google Scholar 

  29. Chatterjee S, Khunti K, Davies M (2017) Type 2 diabetes. Lancet 389:2239–2251

    Article  CAS  PubMed  Google Scholar 

  30. Gomis R, Artola S, Conthe P, Vidal J, Casamor R, Font B, Grupo de Estudio OBEDIA (2014) Prevalencia de diabetes mellitus tipo 2 en pacientes ambulatorios con sobrepeso u obesidad en España. Estudio OBEDIA. Med Clin 142:485–492

    Article  Google Scholar 

  31. Rajan TM, Menon V (2017) Psychiatric disorders and obesity: a review of association studies. J Postgrad Med 63:182–190

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Jantaratnotai N, Mosikanon K, Lee Y, McIntyre RS (2017) The interface of depression and obesity. Obes Res Clin Pract 11:1–10

    Article  PubMed  Google Scholar 

  33. Han SJ, Kim HJ, Choi YJ, Lee KW, Kim DJ (2013) Increased risk of suicidal ideation in Korean adults with both diabetes and depression. Diabetes Res Clin Pract 101:e14

    Article  PubMed  Google Scholar 

  34. ten Have M, de Graaf R, van Dorsselaer S, Verdurmen J, Van Land H, Vollebergh W (2009) Incidence and course of suicidal ideation and suicide attempts in the general population. Can J Psychiatry 54:824–833

    Article  PubMed  Google Scholar 

  35. Handley TE, Inder KJ, Kay Lambkin FJ, Stain HJ, Fitzgeranld M, Lewin TJ (2012) Contributors to suicidality in rural communities: beyond the effects of depression. BMC Psychiatry 12:105

    Article  PubMed  PubMed Central  Google Scholar 

  36. Ceretta LB, Reus GZ, Abelaira HM, Jornada LK, Schwalm MT, Hoepers NJ (2012) Increased prevalence of mood disorders and suicidal ideation in type 2 diabetic patients. Acta Diabetol 49(Suppl 1):S227–S234

    Article  PubMed  Google Scholar 

  37. Wang B, An X, Shi X, Zhang J (2017) Suicide risk in patients with diabetes: a systematic review and meta-analysis. EJE 177:R169–R181

    Article  CAS  Google Scholar 

  38. De Ridder D, Geenen R, Kuijer R, van Middendorp H (2008) Psychological adjustment to chronic disease. Lancet 372:246–255

    Article  PubMed  Google Scholar 

  39. Ehrmann D, Schmitt A, Reimer A, Haak T, Kulzer B, Hermanns N (2017) The affective and somatic side of depression: subtypes of depressive symptoms show diametrically opposed associations with glycemic control in people with type 1 diabetes. Acta Diabetol 54:749–756

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain

    J. Nicolau, C. Conchillo, P. Sanchís, J. Blanco, J. M. Romerosa, A. Bonet & L. Masmiquel

  2. Diabetes and Metabolism Research Unit, Vall d’Hebron Research Institute and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Barcelona, Spain

    R. Simó

  3. Hormonal Laboratory Department, Hospital Son Llàtzer, Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain

    R. Fortuny

Authors
  1. J. Nicolau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Simó
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Conchillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Sanchís
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Blanco
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. M. Romerosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. Fortuny
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Bonet
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. L. Masmiquel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Nicolau.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of the Hospital Son Llàtzer.

Informed consent

Written informed consent was obtained for both groups prior to study participation.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nicolau, J., Simó, R., Conchillo, C. et al. Differences in the cluster of depressive symptoms between subjects with type 2 diabetes and individuals with a major depressive disorder and without diabetes. J Endocrinol Invest 42, 881–888 (2019). https://doi.org/10.1007/s40618-019-01020-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-019-01020-x

Keywords

Search

Navigation