The association of minor and major depression with health problem-solving and diabetes self-care activities in a clinic-based population of adults with type 2 diabetes mellitus.

We examined whether problem-solving and diabetes self-management behaviors differ by depression diagnosis - major depressive disorder (MDD) and minor depressive disorder (MinDD) - in adults with Type 2 diabetes (T2DM). We screened a clinical sample of 702 adults with T2DM for depression, identified 52 positive and a sample of 51 negative individuals, and performed a structured diagnostic psychiatric interview. MDD (n = 24), MinDD (n = 17), and no depression (n = 62) were diagnosed using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria. Health Problem-Solving Scale (HPSS) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaires determined problem-solving and T2DM self-management skills, respectively. We compared HPSS and SDSCA scores by depression diagnosis, adjusting for age, sex, race, and diabetes duration, using linear regression. Total HPSS scores for MDD (β = −4.38; p < 0.001) and MinDD (β = −2.77; p < 0.01) were lower than no depression. Total SDSCA score for MDD (β = −10.1; p < 0.01) was lower than for no depression, and was partially explained by total HPSS. MinDD and MDD individuals with T2DM have impaired problem-solving ability. MDD individuals had impaired diabetes self-management, partially explained by impaired problem-solving. Future studies should assess problem-solving therapy to treat T2DM and MinDD and integrated problem-solving with diabetes self-management for those with T2DM and MDD.

我们研究了在2型糖尿病（T2DM）成人患者中，解决问题的能力和糖尿病自我管理行为是否因抑郁症诊断（重度抑郁症（MDD）和轻度抑郁症（MinDD））而有所不同。 我们对702名患有T2DM的成人临床样本进行了抑郁症筛查，确定了52名阳性个体和51名阴性个体样本，并进行了结构化的精神病学诊断访谈。根据《精神障碍诊断与统计手册》第四版（DSM - IV）文本修订版标准，诊断出重度抑郁症（n = 24）、轻度抑郁症（n = 17）和无抑郁症（n = 62）。健康问题解决量表（HPSS）和糖尿病自我护理活动总结（SDSCA）问卷分别用于确定解决问题的能力和T2DM自我管理技能。我们通过线性回归，在调整年龄、性别、种族和糖尿病病程后，按抑郁症诊断比较了HPSS和SDSCA得分。 重度抑郁症（β = -4.38；p < 0.001）和轻度抑郁症（β = -2.77；p < 0.01）的HPSS总分低于无抑郁症者。重度抑郁症的SDSCA总分（β = -10.1；p < 0.01）低于无抑郁症者，且这在一定程度上可由HPSS总分来解释。 患有T2DM的轻度抑郁症和重度抑郁症患者解决问题的能力受损。重度抑郁症患者的糖尿病自我管理能力受损，部分可由解决问题能力受损来解释。未来的研究应评估解决问题疗法对治疗T2DM和轻度抑郁症的作用，以及对患有T2DM和重度抑郁症的患者将解决问题与糖尿病自我管理相结合的作用。