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To determine the prevalence rate of and risk factors for depression in Croatian Type 2 diabetic patients. Depressive mood was examined in 384 randomly selected outpatients with Type 2 diabetes. Center for Epidemiological Studies Depression Scale (CES-D) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) were used to identify depressive disturbances. The groups with CES-D ≥ 16 and < 16 were compared with respect to demographic, psychological and clinical characteristics. Regression analysis was used to determine risk factors for depression. Of the examined patients, 22% had CES-D scores ≥ 16, and in 33% of them clinical depression was confirmed by the psychiatric interview. Depressed patients compared with the non-depressed ones reported more diabetes-related problems and poorer well-being ( t = 6.71, P < 0.001 and t = 11.98, P < 0.001, respectively). Multiple regression analysis indicated female gender, experienced support and the level of emotional well-being to predict depression ( R = 0.74, F = 15.3, P < 0.001). The obtained data indicate that the prevalence rate in Croatian Type 2 diabetic patients is comparable to findings from other cultural settings. Depressive symptoms can be predicted by psychological rather than disease-related variables. Psychological care for diabetic patients may be necessary to prevent depressive symptomatology. Diabet. Med. 22, 942–945 (2005) [ABSTRACT FROM AUTHOR]

Objective: The study was aimed at exploring a 1-year course of depression in persons with type 2 diabetes and analysing demographic, disease-related, and psychological variables that may predict persistent depressive symptoms., Patients and Methods: One hundred patients from a randomly selected sample of 470 outpatients were found to be suffering from severe depressive symptoms. They were followed and re-examined for depression after 1 year. Baseline depression was assessed by the Center for Epidemiologic Studies--Depression scale (CES-D) and a face-to-face diagnostic interview relying on the DSM-IV. Nonparametric tests for between-group differences were used to compare patients who recovered from depression with those who still suffered from severe depressive symptoms. Multiple logistic regression was used to determine predictors of depression persistence., Results: Seventy-nine of 100 patients with baseline depression scores indicative of severe depression were reached at 1-year follow-up. Among them, 53% were shown to have improved depressive symptoms to CES-D <16, while 47% continued to suffer from severe depressive disturbances (CES-D >or=16). Logistic regression analysis indicated that psychosocial variables predicted persistently elevated depressive symptoms better than demographic and diabetes-related ones. Clinical depression at baseline (OR=3.8, CI 1.31-10.98, P=.01), diabetes-related distress (OR=3.3, CI 1.01-10.98, P=.05), and social and physical quality-of-life aspects (OR=0.92, CI 0.88-0.97, P=.0005 and OR=0.94, CI 0.90-0.98, P=.002, respectively) were shown to be independent predictors of 1-year depression outcomes., Conclusions: Severity of baseline depression, a degree to which depression disrupted the patients' quality of life, and concomitant emotional problems related to diabetes were shown to be associated with persistently elevated depressive symptoms.

It has been hypothesized that coverage of diabetes-specific issues (e.g. coping with complications, incapacity, pain) during psychotherapy may optimize the likelihood of treatment success for depression in patients with diabetes. However, it is still unclear how often depression is confounded by diabetes-specific emotional problems. We aim to determine the levels of diabetes-specific emotional problems in diabetic individuals with high versus low levels of depression in a sample of 539 outpatients with diabetes (202 Dutch, 185 Croatian and 152 English). Subjects completed the Center for Epidemiological Studies Depression and the Problem Areas in Diabetes scales. Percentages of patients with high depression scores were: 39 and 34% (Croatian men and women), 19 and 21% (Dutch men and women), 19 and 39% (English men and women). Moreover, 79% (Croatian), 47% (Dutch) and 41% (English) of the patients with a severe depression score reported to have four or more serious diabetes-specific emotional problems. For patients with low depression scores, these percentages were: 29% (Croatian), 11% (Dutch) and 1% (English). Serious diabetes-specific emotional problems are particularly prevalent in depressed diabetes patients. Randomized controlled trials are warranted to test whether coverage of diabetes-specific issues during psychotherapy can further improve the treatment of depression in diabetes.