Journal List > Korean Diabetes J > v.33(5) > 1002324

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Kim, Lee, Kim, Kim, Na, Kim, Kim, Baek, Kang, Lee, and Song: Depression and Self-care Behavior in Patients with Diabetes Mellitus
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2009; 33(5): 432-438.

Published online: 31 October 2009

DOI: https://doi.org/10.4093/kdj.2009.33.5.432

Depression and Self-care Behavior in Patients with Diabetes Mellitus

Su Yoen Kim, Jae Ho Lee, Ha Neul Kim, Dong Kyu Kim, Young Na, Guil Sun Kim, Mee Kyoung Kim, Ki Hyun Baek, Moo IL Kang, Kwang Woo Lee, Ki-Ho Song

Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

Corresponding author (kihos@catholic.ac.kr)

Received 10 March 2009       Accepted 1 September 2009

Copyright © 2009 Korean Diabetes Association

Abstract

Background

Depression is known to be a risk factor for type 2 diabetes mellitus. Conversely, diabetes is also a risk factor for depression, and patients with diabetes have nearly twice the risk of comorbid depression as the general population. Depression in patients with diabetes may cause poor clinical outcomes through lower adherence to self-care activities such as exercise, diet control, and glucose monitoring. Furthermore, diabetic patients with depression are more likely to suffer from microvascular or macrovascular complications. We explored the prevalence of major depressive disorder in Korean diabetic patients and its impact on self-care activities and glucose control.

Methods

We surveyed depressive symptoms and self-care activities in 191 type 2 diabetic patients from the outpatient clinic of the St. Mary's hospital. Two questionnaires were used for assessment, the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS) and the Summary of Diabetes Self-Care Activities (SDSCA).

Results

Of the 191 respondents who completed questionnaires, 39 (20.4%) patients were categorized as having major depressive disorder. Among the depressed patients, only six (15.3%) had been previously evaluated and managed for their psychiatric problems. The incidence of depression was significantly higher in female diabetic patients compared to patients without depression (74.4% vs. 45.4%, P < 0.001). Patients with depression showed significantly poorer diet control (18.5 vs. 15.9, P = 0.046) and less glucose monitoring (4.1 vs. 2.7, P = 0.047). However, there were no differences in exercise, foot care, or smoking status between the two groups. Additionally, metabolic parameters such as HbA1C and lipid profile were not significantly different between the two groups.

Conclusion

Many diabetic patients are suffering from depression and exhibit poorer self-care activities than patients without depression. Identifying and managing depressed diabetic patients may help improve their self-care activities.

Keywords: Diabetes Complications, Diabetes, Depression, Self-care

Figures and Tables

Table 1
Classification of patients according to HANDS score
kdj-33-432-i001

Data are n (%). HANDS, Harvard department of psychiatry/national depression screening day scale.

Table 2
Patients characteristics
kdj-33-432-i002

Data are n (%) or means ± SD. Statistical comparisons are between patients with scores above or below the HANDS cutoff using χ2 or Student's t test; ACR, albumin-to-creatinine ratio in random urine samples; HANDS, Harvard department of psychiatry/national depression screening day scale; HDL-cholesterol, high density lipoprotein cholesterol; LDL-cholesterol, low density lipoprotein cholesterol.

Table 3
Score of self-care behaviors by HANDS cutoff score
kdj-33-432-i003

Data are means ± SD. Student's t test were used to statistical comparisons between two groups. HANDS, Harvard department of psychiatry/national depression screening day scale.

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