Address of the institution at which the work was carried out: Div. Molecular Metabolism and Diabetes, Tohoku Univ. Grad. Sch. Med., Sendai, 980-8575, Japan
Neuropathy is associated with depression independently of health-related quality of life in Japanese patients with diabetes
Article first published online: 1 DEC 2008
© 2008 The Authors. Journal compilation © 2008 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 63, Issue 1, pages 65–72, February 2009
How to Cite
Yoshida, S., Hirai, M., Suzuki, S., Awata, S. and Oka, Y. (2009), Neuropathy is associated with depression independently of health-related quality of life in Japanese patients with diabetes. Psychiatry and Clinical Neurosciences, 63: 65–72. doi: 10.1111/j.1440-1819.2008.01889.x
- Issue published online: 15 JAN 2009
- Article first published online: 1 DEC 2008
- Received 11 February 2008; revised 13 September 2008; accepted 14 September 2008.
- mental health;
- quality of life
Objectives: To identify factors independently associated with depression in Japanese patients with diabetes, after controlling for potential confounding factors.
Methods: Among 197 outpatients with diabetes, 129 (type 1: 24, type 2: 105) completed a questionnaire concerning socio-demographic and health-related variables. Depression screening was done using Zung's Self-Rating Depression Scale test, followed by diagnostic interviews by experienced psychiatrists employing the Diagnostic Statistical Manual of Mental Disorders, 4th edition (DSM-IV).
Results: Forty-seven patients (36.4%) had symptomatological depression. A Self-Rating Depression Scale cut-off score of 40 had good sensitivity (100%) and modest specificity (59%) for detecting major depressive episode, in accordance with the DSM-IV. Diabetic patients suffering from depression were more likely to have neuropathy, retinopathy, body pain, a feeling of poor general health, and lack of social support, than the non-depressed patients. However, age, gender, marital status, diabetes type, insulin requirement, duration of diabetes, hemoglobin A1c (HbA1c) and the presence of nephropathy did not differ between the two groups. In multivariate logistic regression analysis, body pain (OR 3.26, 95% CI 1.31–8.08) and the presence of microvascular complications (OR 2.81, 95% CI 1.13–6.98) were independent factors associated with depression. Specifically, diabetic neuropathy (OR 3.10, 95% CI 1.17–8.22) was associated with depression independently of age, gender, marital status, social supports, quality of life, diabetes type, duration of diabetes, HbA1c, and insulin requirement.
Conclusions: A diabetic complication, specifically neuropathy, was independently associated with depression in patients with diabetes. The present findings indicate the need to find a biological base common to both depression in diabetes and diabetic neuropathy.