Work

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

Year: 2025

Type: article

Abstract: BACKGROUND Diabetes mellitus (DM) is a rapidly growing global health emergency of the 21st 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.

Source: World Journal of Diabetes

DOI: 10.4239/wjd.v16.i4.100638

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

Institutions: Guangzhou University of Chinese Medicine, University of Macau, Guangzhou University

Language: English

Topic: Diabetes Management and Education

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: National Natural Science Foundation of China