Journal Article

The association of minor and major depression with health problem-solving and diabetes self-care activities in a clinic-based population of adults with type 2 diabetes mellitus

Golden, Sherita Hill, Shin, Na, Hill-Briggs, Felicia, Langan, Susan, Payne, Jennifer L., Lyketsos, Constantine

2017

Overview

We examined whether problem-solving and diabetes self-management behaviors differ by depression diagnosis – major depressive disorder (MDD) and minor depressive disorder (MinDD) – in adults with Type 2 diabetes (T2DM). We screened a clinical sample of 702 adults with T2DM for depression, identified 52 positive and a sample of 51 negative individuals, and performed a structured diagnostic psychiatric interview. MDD (n=24), MinDD (n=17), and no depression (n=62) were diagnosed using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria. Health Problem-Solving Scale (HPSS) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaires determined problem-solving and T2DM self-management skills, respectively. We compared HPSS and SDSCA scores by depression diagnosis, adjusting for age, sex, race, and diabetes duration, using linear regression. Total HPSS scores for MDD (β=−4.38; p<0.001) and MinDD (β=−2.77; p<0.01) were lower than no depression. Total SDSCA score for MDD (β=−10.1; p<0.01) was lower than for no depression, and was partially explained by total HPSS. MinDD and MDD individuals with T2DM have impaired problem-solving ability. MDD individuals had impaired diabetes self-management, partially explained by impaired problem-solving. Future studies should assess problem-solving therapy to treat T2DM and MinDD and integrated problem-solving with diabetes self-management for those with T2DM and MDD.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Academic Medical Centers / Activities of daily living / Aged / Antidepressants / Baltimore - epidemiology / Combined Modality Therapy - adverse effects / Combined Modality Therapy - psychology / Comorbidity / Cost of Illness / Depression / Depression - complications / Depression - epidemiology / Depression - physiopathology / Depression - psychology / Depressive Disorder, Major - complications / Depressive Disorder, Major - epidemiology / Depressive Disorder, Major - physiopathology / Depressive Disorder, Major - psychology / Diabetes / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - psychology / Diabetes Mellitus, Type 2 - therapy / Diabetes self-care activities / Diagnostic and Statistical Manual of Mental Disorders / Disease management / Endocrinology & Metabolism / Female / Health behavior / Health Knowledge, Attitudes, Practice / Humans / Major depressive disorder / Male / Medical screening / Mental depression / Mental disorders / Middle Aged / Minor depressive disorder / Outpatient Clinics, Hospital / Patient Compliance / Patients / Prevalence / Problem Solving / Psychotropic drugs / Questionnaires / Self Report / Self-Management - psychology / Specific Learning Disorder - complications / Specific Learning Disorder - etiology / Specific Learning Disorder - psychology / Stress, Psychological - etiology / Stress, Psychological - physiopathology / Stress, Psychological - psychology / Type 2 diabetes mellitus