Trajectories of depression in adults with newly diagnosed type 1 diabetes: results from the German Multicenter Diabetes Cohort Study.

Faculty/Professorship: Clinical Psychology and Psychotherapy  
Author(s): Kampling, Hanna; Petrak, Frank; Farin, Erik; Kulzer, Bernhard ; Herpertz, Stephan; Mittag, Oskar
Title of the Journal: Diabetologia
ISSN: 0012-186X
Publisher Information: Berlin ; Heidelberg : Springer
Year of publication: 2017
Volume: 60
Issue: 1
Pages: 60-68
Language(s): English
DOI: 10.1007/s00125-016-4123-0
There is a paucity of longitudinal data on type 1 diabetes and depression, especially in adults. The present study prospectively analysed trajectories of depressive symptoms in adults during the first 5 years of living with type 1 diabetes. We aimed to identify distinct trajectories of depressive symptoms and to examine how they affect diabetes outcome.We reanalysed data from a prospective multicentre observational cohort study including 313 adults with newly diagnosed type 1 diabetes. At baseline and in annual postal surveys over 5 consecutive years, we gathered patient characteristics and behavioural and psychosocial data (e.g. Symptom Checklist-90-R [SCL-90-R]). Medical data (e.g. HbA1c levels) was obtained from the treating physicians. We applied growth mixture modelling (GMM) to identify distinct trajectories of depression over time.Five years after diagnosis, 7.8% (n = 20) of patients were moderately depressed and 10.2% (n = 26) were severely depressed. GMM statistics identified three possible models of trajectories (class 1, 'no depressive symptoms'; class 2, 'worsening depressive symptoms that improve after 2 years'; class 3, 'worsening depressive symptoms'). Severity of depression symptoms at baseline (subscale of the SCL-90-R questionnaire) significantly predicted membership of classes 2 and 3 vs class 1. After 5 years, higher HbA1c values were detected in class 3 patients (mean = 8.2%, 66 mmol/mol) compared with class 1 and class 2 (both: mean = 7.2%, 55 mmol/mol).We identified distinct trajectories of depressive symptoms that are also relevant for diabetes outcome. Patients with worsening depressive symptoms over time exhibited poor glycaemic control after the first 5 years of living with diabetes. They also exhibited a reduced quality of life and increased diabetes-related distress.
Keywords: Adults, Depression, Growth mixture modelling, Longitudinal data, Onset cohort
Peer Reviewed: Ja
International Distribution: Ja
Open Access Journal: Ja
Type: Article
Year of publication: 22. June 2018