Prevalence and associated factors of depressive symptoms in Chinese diabetic patients: A study based on Andersen's behavioral model.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-04-15 DOI:10.4239/wjd.v16.i4.100638

Wen-Hui Xiao, Xiao-Cong Yang, Si-Jie Xu, Ying Bian, Guan-Yang Zou

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引用次数: 0

Abstract

Background: Diabetes mellitus (DM) is a rapidly growing global health emergency of the 21^st century. Comorbidities, such as DM and depression, are common, presenting challenges to the healthcare system.

Aim: To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.

Methods: Participants were selected from the 2018 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale, with a score of 10 or more indicating depression. Group differences were compared using analysis of variance and χ ² tests. Binary logistic regression was conducted to explore the odds ratios (ORs) of independent variables. Following Andersen's behavioral model, predisposing, enabling, health need, and health behavior variables were introduced stepwise into the logistic model.

Results: Of the 1673 patients with diabetes, 41.4% had depressive symptoms. Regarding the predisposing characteristics, patients who were male (OR 0.426, P < 0.05), married (OR 0.634, P < 0.05), and received a high school education or higher (OR 0.432, P < 0.05) reported fewer depressive symptoms. Healthcare needs, including better self-rated health (OR 0.458 for fair and OR 0.247 for good, P < 0.05) and more sleep (OR 0.642, P < 0.05), were associated with a lower likelihood of depressive symptoms. In contrast, pain (OR 1.440 for mild and OR 2.644 for severe, P < 0.05) and impairment in the basic activities of daily living (OR 1.886, P < 0.05) were inversely associated. Additionally, patients highly satisfied with healthcare services (OR 0.579, P < 0.05) were less likely to have depressive symptoms.

Conclusion: Nearly half of the patients with DM reported depressive symptoms, which were strongly associated with predisposing characteristics and healthcare needs, particularly physical pain and impairment in basic activities of daily living. Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.

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中国糖尿病患者抑郁症状的患病率及相关因素：基于Andersen行为模型的研究

背景：糖尿病（DM）是21世纪快速增长的全球性突发卫生事件。糖尿病和抑郁症等合并症很常见，给医疗保健系统带来了挑战。目的：了解糖尿病患者抑郁的患病率及其相关因素，加强对该患者组抑郁的管理。方法：从2018年中国健康与退休纵向研究中选择参与者。抑郁症状是用10项流行病学研究中心抑郁量表进行评估的，得分在10分或10分以上表明患有抑郁症。采用方差分析和χ 2检验比较组间差异。采用二元logistic回归分析自变量的比值比（or）。根据Andersen的行为模型，在logistic模型中逐步引入易感、使能、健康需要和健康行为变量。结果：1673例糖尿病患者中，41.4%有抑郁症状。易患特征方面，男性（OR 0.426, P < 0.05）、已婚（OR 0.634, P < 0.05）、高中及以上文化程度（OR 0.432, P < 0.05）患者抑郁症状较少。医疗保健需求，包括更好的自我评价健康（一般OR 0.458，良好OR 0.247, P < 0.05）和更多的睡眠（OR 0.642, P < 0.05），与抑郁症状的可能性较低相关。相比之下，疼痛（轻度OR 1.440，重度OR 2.644, P < 0.05）与日常生活基本活动障碍（OR 1.886, P < 0.05）呈负相关。此外，对医疗服务高度满意的患者出现抑郁症状的可能性较低（OR 0.579, P < 0.05）。结论：近一半的糖尿病患者报告抑郁症状，这与易感特征和医疗保健需求密切相关，特别是身体疼痛和日常生活基本活动障碍。我们的研究强调了在糖尿病护理中加强抑郁症筛查和干预以及改善功能障碍管理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.