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Table of Contents
Vol. 79, No. 3, 2010
Issue release date: April 2010
Section title: Regular Article
Psychother Psychosom 2010;79:172–178
(DOI:10.1159/000296135)

Diabetes in Primary Care: Prospective Associations between Depression, Nonadherence and Glycemic Control

Dirmaier J.a · Watzke B.a · Koch U.a · Schulz H.a · Lehnert H.b, d · Pieper L.c · Wittchen H.-U.c
aDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, bFirst Department of Medicine, University of Lübeck, Lübeck, and cInstitute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany; dWarwick Medical School, University Hospital of Coventry, Coventry, UK

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Received: January 16, 2009
Accepted: July 13, 2009
Published online: March 17, 2010
Issue release date: April 2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

Background: Findings are inconsistent regarding the degree to which depression may exert a negative impact on glycemic control in patients with type 2 diabetes. We therefore aimed to examine the longitudinal relationship between depression, behavioral factors, and glycemic control. Methods: In a prospective component of a nationally representative sample, 866 patients with type 2 diabetes aged ≧18 years completed a standardized assessment including a laboratory screening, questionnaires, and diagnostic measures. Subsequent to baseline (t₀), patients were tracked over a period of 12 months (t1). Depression was assessed according to DSM-IV and ICD-10 criteria. Glycemic control was determined by levels of glycosylated hemoglobin (HbA1c); a level of ≧7% was judged as unsatisfactory. Regression analyses were performed to analyze the prospective relationship between depression, medication adherence, diabetes-related health behavior, and HbA1c. Results: Patients with depression at t₀ revealed increased rates of medication nonadherence (adjusted OR: 2.67; CI: 1.38–5.15) at t1. Depression (adjusted regression coefficient: β = 0.96; p = 0.001) and subthreshold depression (β = 1.01; p < 0.001) at t₀ also predicted increased problems with diabetes-related health behavior at t1. Adjusted ORs for poor glycemic control (HbA1c ≧7%) at t1 were also increased for patients with baseline depression (2.01; CI: 1.10–3.69). However, problems with medication adherence as well as problems with diabetes-related health behavior at t₀ did not predict poor glycemic control at t1. Conclusions: In a prospective representative study of patients with type 2 diabetes, baseline depression predicted problems with medication adherence, problems with health-related behaviors, and unsatisfactory glycemic control at follow-up.

© 2010 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Regular Article

Received: January 16, 2009
Accepted: July 13, 2009
Published online: March 17, 2010
Issue release date: April 2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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