OBJECTIVE - To determine the level and pattern of persistent depressive sym
ptoms among adults with diabetes and identify factors associated with incre
ased risk of being persistently depressed.
RESEARCH DESIGN AND METHODS - A self-report depression symptom inventory wa
s administered to 245 patients at two initial time points-the beginning and
end of a comprehensive outpatient diabetes education program-and at 6-mont
h follow-up.
RESULTS - Only 13% of subjects were persistently depressed (i.e., exceeded
the criterion for depression symptoms at all three time points). The rate o
f being depressed at follow-up was 10% for those negative for depression sy
mptoms at either of the initial time points, 36% for those positive at one
initial time point, and 73% for those positive at bath initial time points
(P < 0.0001), Those at increased risk for being persistently depressed were
those who did not graduate from high school, had more than two complicatio
ns of diabetes, and were not treated with insulin.
CONCLUSIONS - Persistent depressive symptomatology is present in a substant
ial number of diabetic adults and can be effectively predicted using simple
screening instruments during initial contacts. Risk factors for being pers
istently depressed only partly overlap those for transient depressive sympt
oms and represent a possible biological dimension.