Depressive symptoms prior to and following insulin initiation in patients with type 2 diabetes mellitus : Prevalence, risk factors and effect on physician resource utilization

Professorship/Faculty: Clinical Psychology and Psychotherapy  
Author(s): Dzida, Grzegorz; Karnieli, Eddy; Svendsen, Anne Louise; Steensen Sølje, Kristine; Hermanns, Norbert
Title of the Journal: Primary Care Diabetes
ISSN: 1751-9918
Publisher Information: Amsterdam [u.a.] : Elsevier
Year of publication: 2015
Volume: 9
Issue: 5
Pages: 346-353
Language(s): English
DOI: 10.1016/j.pcd.2015.01.002
Aims: To study the frequency and intensity of depressive symptoms and associations with physician resource utilisation following insulin initiation in patients with type 2 diabetes mellitus.
Methods: SOLVE was a 24-week observational study. In this sub-analysis of data from Poland, depressive symptoms were evaluated using the Patient Health Questionnaire (PHQ)-9.
Results: PHQ-9 was completed by 942 of 1169 patients (80.6%) at baseline, and 751 (64.2%) at both baseline and final (24-week) visit. PHQ-9 scores indicated depressive symptoms in 45.6% (n = 430) at baseline, and 27.2% (n = 223) at final visit. Mean PHQ-9 change was −2.38 [95% CI −2.73, −2.02], p < 0.001. Depressive symptoms at baseline (OR 6.32, p < 0.001), microvascular disease (OR 2.45, p = 0.016), number of physician contacts (OR 1.16, p = 0.009), and change in HbA1c (OR 0.60, p = 0.025) were independently associated with moderate/severe depressive symptoms at final visit. Patients with more severe depressive symptoms spent more time training to self-inject (p = 0.0016), self-adjust (p = 0.0023) and manage other aspects of insulin delivery (p < 0.0001). Patients with persistent depressive symptoms had more telephone contacts and dose changes at final visit than those without (both p < 0.05).
Keywords: Type 2 diabetes, Depressive symptoms, Depression, PHQ-9, Healthcare resource utilisation
Peer Reviewed: Ja
International Distribution: Ja
Document Type: Article
Year of publication: 5. April 2016