Advertisement

Course of screening-based depression in young adults with a long type 1 diabetes duration: Prevalence and transition probabilities – A cohort study

  • Christina Baechle
    Correspondence
    Corresponding author at: German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Institute for Biometrics and Epidemiology, Auf’m Hennekamp 65, D-40225 Düsseldorf, Germany.
    Affiliations
    Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf’m Hennekamp 65, D-40225 Düsseldorf, Germany

    German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
    Search for articles by this author
  • Anna Stahl-Pehe
    Affiliations
    Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf’m Hennekamp 65, D-40225 Düsseldorf, Germany

    German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
    Search for articles by this author
  • Katty Castillo
    Affiliations
    Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf’m Hennekamp 65, D-40225 Düsseldorf, Germany

    German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
    Search for articles by this author
  • Karin Lange
    Affiliations
    Medical Psychology Unit, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
    Search for articles by this author
  • Reinhard W. Holl
    Affiliations
    Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, D-89081 Ulm, Germany

    German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
    Search for articles by this author
  • Joachim Rosenbauer
    Affiliations
    Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf’m Hennekamp 65, D-40225 Düsseldorf, Germany

    German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
    Search for articles by this author
  • In cooperation with the German Pediatric Surveillance Unit ESPED, the DPV-Science initiative, supported by the German Center for Diabetes Research DZD
Published:January 28, 2022DOI:https://doi.org/10.1016/j.diabres.2022.109220

      Highlights

      • The prevalence of screening-based depression (SBD) was 17.7% in women/7.0% in men.
      • The prevalence of SBD varied with age, sex, HbA1c, and smoking behavior.
      • Transition probabilities for developing SBD were more than twofold higher in women.
      • Previous SBD, living arrangement and German region mainly predicted current SBD.
      • Results emphasize the relevance of regular depression screenings in young adults.

      Abstract

      Aims

      To extend the current knowledge of the prevalence and course of screening-based depression (SBD) and its predictors in emerging adults with a long type 1 diabetes duration.

      Methods

      A total of 487 young adults (64.7% women, mean age 24.0 years) who participated in a nationwide cohort study provided data on SBD (Patient Health Questionnaire (PHQ-9) score ≥ 10). We estimated the overall and age- and sex-specific prevalence of SBD, identified the associated covariates, and determined the transition probabilities between SBD states using adjusted first-order Markov transition models.

      Results

      The prevalence of SBD was 17.7% in women and 7.0% in men. A total of 70.4% (95%-CI 57.4%; 80.8%) of the participants with SBD at the first screening still had SBD at the three-year follow-up. Of the subjects without SBD at baseline, 6.9% (4.9%; 9.8%) had SBD at follow-up. The main predictor of current SBD was previous SBD (OR 39.0 (15.4; 98.6)), followed by living in one’s own or in a shared apartment vs. living with both parents (OR: 2.75 (1.03; 7.36)).

      Conclusions

      Using an innovative analytical approach, emerging adults with a long diabetes duration demonstrated a moderate rate of incident SBD but a high rate of persistent SBD.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Diabetes Research and Clinical Practice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Shubrook J.H.
        • Brannan G.D.
        • Wapner A.
        • Klein G.
        • Schwartz F.L.
        Time Needed for Diabetes Self-Care. Nationwide Survey of Certified Diabetes Educators.
        Diabetes Spectr. 2018; 31: 267-271
        • Sundberg F.
        • Barnard K.
        • Cato A.
        • de Beaufort C.
        • Dimeglio L.A.
        • Dooley G.
        • et al.
        Managing diabetes in preschool children.
        Pediatr Diabetes. 2017; 18: 499-517
      1. Gesellschaft für Transitionsmedizin. S3-Leitlinie: Transition von der Pädiatrie in die Erwachsenenmedizin. Version 1.1 vom 22.04.2021, 2021. Available from https://www.awmf.org/leitlinien/detail/ll/186-001.html [accessed 24 June 2021].

        • Kapellen T.M.
        • Müther S.
        • Schwandt A.
        • Grulich-Henn J.
        • Schenk B.
        • Schwab K.O.
        • et al.
        Transition to adult diabetes care in Germany-High risk for acute complications and declining metabolic control during the transition phase.
        Pediatr Diabetes. 2018;
        • Picozzi A.
        • DeLuca F.
        Depression and glycemic control in adolescent diabetics. Evaluating possible association between depression and hemoglobin A1c.
        Public Health. 2019; 170: 32-37
        • Oris L.
        • Luyckx K.
        • Rassart J.
        • Goethals E.
        • Bijttebier P.
        • Goubert L.
        • et al.
        Change and stability in depressive symptoms in young adults with type 1 diabetes.
        Diabetes Res Clin Pract. 2016; 111: 93-96
        • Wolfgram P.
        • Zhang L.
        • Simpson P.
        • Fiallo-Scharer R.
        Clinical associations of quarterly Patient Health Questionnaire-9 depression screening results in adolescents with type 1 diabetes.
        Pediatr Diabetes. 2020; 21: 871-877
        • Trief P.M.
        • Xing D.
        • Foster N.C.
        • Maahs D.M.
        • Kittelsrud J.M.
        • Olson B.A.
        • et al.
        Depression in adults in the T1D Exchange Clinic Registry.
        Diabetes Care. 2014; 37: 1563-1572
        • Johnson B.
        • Elliott J.
        • Scott A.
        • Heller S.
        • Eiser C.
        Medical and psychological outcomes for young adults with Type 1 diabetes. No improvement despite recent advances in diabetes care.
        Diabet Med. 2014; 31: 227-231
        • Yayan E.H.
        • Zengin M.
        • Erden Karabulut Y.
        • Akıncı A.
        The relationship between the quality of life and depression levels of young people with type I diabetes.
        Perspect Psychiatr Care. 2019; 55: 291-299
        • Hilliard M.E.
        • Wu Y.P.
        • Rausch J.
        • Dolan L.M.
        • Hood K.K.
        Predictors of deteriorations in diabetes management and control in adolescents with type 1 diabetes.
        J Adolesc Health. 2013; 52: 28-34
        • Johnson B.
        • Eiser C.
        • Young V.
        • Brierley S.
        • Heller S.
        Prevalence of depression among young people with Type 1 diabetes: a systematic review.
        Diabet Med. 2013; 30: 199-208
        • Insabella G.
        • Grey M.
        • Knafl G.
        • Tamborlane W.
        The transition to young adulthood in youth with type 1 diabetes on intensive treatment.
        Pediatr Diabetes. 2007; 8: 228-234
        • Whittemore R.
        • Kanner S.
        • Singleton S.
        • Hamrin V.
        • Chiu J.
        • Grey M.
        Correlates of depressive symptoms in adolescents with type 1 diabetes.
        Pediatr Diabetes. 2002; 3: 135-143
        • Baucom K.J.W.
        • Turner S.L.
        • Tracy E.L.
        • Berg C.A.
        • Wiebe D.J.
        Depressive symptoms and diabetes management from late adolescence to emerging adulthood.
        Health Psychol. 2018; 37: 716-724
        • Rawshani A.
        • Sattar N.
        • Franzén S.
        • Rawshani A.
        • Hattersley A.T.
        • Svensson A.-M.
        • et al.
        Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset. A nationwide, register-based cohort study.
        The Lancet. 2018; 392: 477-486
        • Stahl A.
        • Straßburger K.
        • Lange K.
        • Bächle C.
        • Holl R.W.
        • Giani G.
        • et al.
        Health-related quality of life among German youths with early-onset and long-duration type 1 diabetes.
        Diabetes Care. 2012; 35: 1736-1742
        • van Steenbergen-Weijenburg K.M.
        • de Vroege L.
        • Ploeger R.R.
        • Brals J.W.
        • Vloedbeld M.G.
        • Veneman T.F.
        • et al.
        Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics.
        BMC Health Serv Res. 2010; 10: 235
      2. American Psychiatric Association. Severity Measure for Depression—Adult, 2014. Available from http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures [accessed 11 October 2014].

        • Trief P.M.
        • Foster N.C.
        • Chaytor N.
        • Hilliard M.E.
        • Kittelsrud J.M.
        • Jaser S.S.
        • et al.
        Longitudinal Changes in Depression Symptoms and Glycemia in Adults With Type 1 Diabetes.
        Diabetes Care. 2019; 42: 1194-1201
        • Kroenke K.
        • Spitzer R.L.
        • Williams J.B.W.
        • Löwe B.
        The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.
        Gen Hosp Psychiatry. 2010; 32: 345-359
      3. Stanford Patient Education Research Center. Personal Health Questionnaire Depression Scale (PHQ-9). Available from http://nwmms.com.au/wp-content/uploads/2017/03/phqStanford.pdf [accessed 16 April 2021].

      4. Joode JW de, van Dijk SEM, Walburg FS, Bosmans JE, van Marwijk HWJ, Boer MR de, van Tulder MW, Adriaanse MC. Diagnostic accuracy of depression questionnaires in adult patients with diabetes. A systematic review and meta-analysis. PLoS ONE 2019;14:e0218512.

      5. Diggle PJ, Heagerty P, Liang K-Y, Zeger SL. Analysis of longitudinal data. 2. ed., reprinted. New York, Oxford Univ. Press; 2002 [Oxford statistical science series; vol 25].

        • Schaakxs R.
        • Comijs H.C.
        • van der Mast R.C.
        • Schoevers R.A.
        • Beekman A.T.F.
        • Penninx B.W.J.H.
        Risk Factors for Depression. Differential Across Age?.
        Am J Geriatr Psychiatry. 2017; 25: 966-977
        • Roy T.
        • Lloyd C.E.
        Epidemiology of depression and diabetes: a systematic review.
        J Affect Disord. 2012; 142: S8-S21
      6. Hastie T, Tibshirani R, Friedman J. The elements of statistical learning: Data mining, inference, and prediction. New York: Springer; 2001 [Springer series in statistics].

        • Pan W.
        Akaike's information criterion in generalized estimating equations.
        Biometrics. 2001; 57: 120-125
      7. Agresti, A. Categorical Data Analysis. 3. ed. Hoboken, NJ: Wiley-Interscience; 2013 [Wiley series in probability and statistics].

        • Glick B.A.
        • Hong K.M.C.
        • Obrynba K.
        • Kamboj M.K.
        • Hoffman R.P.
        Identifying depressive symptoms among diabetes type and the impact on hemoglobin A1c.
        J Pediatr Endocrinol Metab. 2018; 31: 39-44
        • Busch M.A.
        • Maske U.E.
        • Ryl L.
        • Schlack R.
        • Hapke U.
        Prevalence of depressive symptoms and diagnosed depression among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1).
        Bundesgesundheitsbl. 2013; 56: 733-739
        • Salk R.H.
        • Hyde J.S.
        • Abramson L.Y.
        Gender differences in depression in representative national samples. Meta-analyses of diagnoses and symptoms.
        Psychol Bull. 2017; 143: 783-822
        • Naninck E.F.G.
        • Lucassen P.J.
        • Bakker J.
        Sex differences in adolescent depression. Do sex hormones determine vulnerability?.
        J Neuroendocrinol. 2011; 23: 383-392
        • La Greca A.M.
        • Swales T.
        • Klemp S.
        • Madigan S.
        • Skyler J.
        Adolescents with diabetes: gender differences in psychosocial functioning and glycemic control.
        Children’s Health Care. 1995; 24: 61-78
        • Kampling H.
        • Mittag O.
        • Herpertz S.
        • Baumeister H.
        • Kulzer B.
        • Petrak F.
        Can trajectories of glycemic control be predicted by depression, anxiety, or diabetes-related distress in a prospective cohort of adults with newly diagnosed type 1 diabetes? Results of a five-year follow-up from the German multicenter diabetes cohort study (GMDC-Study).
        Diabetes Res Clin Pract. 2018; 141: 106-117
        • Marker A.M.
        • Patton S.R.
        • McDonough R.J.
        • Feingold H.
        • Simon L.
        • Clements M.A.
        Implementing clinic-wide depression screening for pediatric diabetes. An initiative to improve healthcare processes.
        Pediatr Diabetes. 2019; 20: 964-973
        • Zduńczyk B.
        • Sendela J.
        • Szypowska A.
        High prevalence of depressive symptoms in well-controlled adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion.
        Diabetes Metab Res Rev. 2014; 30: 333-338
      8. Esmaeelzadeh S, Moraros J, Thorpe L, Bird Y. Examining the Association and Directionality between Mental Health Disorders and Substance Use among Adolescents and Young Adults in the U.S. and Canada-A Systematic Review and Meta-Analysis. J Clin Med 2018;7:543.

        • Auzanneau M.
        • Lanzinger S.
        • Bohn B.
        • Kroschwald P.
        • Kuhnle-Krahl U.
        • Holterhus P.M.
        • et al.
        Area deprivation and regional disparities in treatment and outcome quality of 29,284 pediatric patients with type 1 diabetes in Germany. A cross-sectional multicenter DPV analysis.
        Diabetes Care. 2018; 41: 2517-2525
      9. Deutsche Diabetes Gesellschaft (DDG), Arbeitsgemeinschaft für Pädiatrische Diabetologie (AGPD). Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. S3-Leitlinie der DDG und AGPD 2015, 2015.

      10. Bundespsychotherapeutenkammer. Ein Jahr nach der Reform der Psychotherapie-Richtlinie. Wartezeiten 2018. Berlin; 2018. Available from: https://www.bptk.de/wp-content/uploads/2019/01/20180411_bptk_studie_wartezeiten_2018.pdf [accessed 07 December 2021].

        • Tomczyk S.
        • Schmidt S.
        • Muehlan H.
        • Stolzenburg S.
        • Schomerus G.
        A Prospective Study on Structural and Attitudinal Barriers to Professional Help-Seeking for Currently Untreated Mental Health Problems in the Community.
        J Behav Health Serv Res. 2020; 47: 54-69
        • Clarke J.
        • Proudfoot J.
        • Vatiliotis V.
        • Verge C.
        • Holmes-Walker D.J.
        • Campbell L.
        • et al.
        Attitudes towards mental health, mental health research and digital interventions by young adults with type 1 diabetes. A qualitative analysis.
        Health Expectations. 2018; 21: 668-677
        • Kulzer B.
        • Albus C.
        • Herpertz S.
        • Kruse J.
        • Lange K.
        • Lederbogen F.
        • et al.
        Psychosoziales und Diabetes (Teil 1). S2-Leitlinie Psychosoziales und Diabetes - Langfassung.
        Diabetologie und Stoffwechsel. 2013; 8: 198-242