BURDEN OF ILLNESS, METABOLIC CONTROL, AND COMPLICATIONS IN RELATION TO DEPRESSIVE SYMPTOMS IN IDDM PATIENTS

Relationships between demographic-, treatment-, and sickness-related f actors, metabolic control (HbA(1c)), perceived burden of illness, and degree of depressive symptoms were examined in a group of 155 insulin- dependent diabetic patients, aged 35.3 +/- 8.9 years. The patients com pleted a questionnaire measuring depressive symptoms and three aspects of perceived burden of illness. No gender differences in HbA(1c) leve l or occurrence of late diabetic complications were found. Both men an d women showed a modestly elevated degree of depression compared with norm groups. Self-reported burden of illness was strongly related to d epression but was largely unrelated to objective disease-related measu res. Level of depression was correlated neither with degree of metabol ic control nor with the presence of such late diabetic complications a s retinopathy and nephropathy. Some 44 % of the variance in depression could be explained by worries about complications in those patients w ith the lowest HbA(1c) levels, by perceived restrictions in everyday l ife in patients with intermediate metabolic control, and by problems o f glycaemic regulation in patients with poor metabolic control. Degree of depression was largely unrelated to disease severity, but was foun d to be related to the perceived daily burden of living with the disea se, the specific worries and concerns associated with a depressed mood varying with degree of metabolic control. (C) 1997 by John Wiley & So ns, Ltd.