Persistence of depressive symptoms in diabetic adults

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.