Contributors to depression in Latino and European-American patients with type 2 diabetes

OBJECTIVE - To deter-mine the independent and cumulative contributions of d iabetes and other life stresses on depression and anxiety in Latino and Eur opean-American (EA) patients with diabetes. RESEARCH DESIGN AND METHODS - A total of 75 Latino and 113 EA patients with type 2 diabetes, recruited from managed care settings, were assessed regar ding three groups of potential Stresses: demographics (age, sex, and educat ion), disease status (functional impact, time since diagnosis, comorbiditie s, HbA(1c) and BMI), an family stress (financial stress, spouse conflict re solution, and family closeness). Dependent variables were depression (Cente r for Epidemiological Studies-Depression scale [CES-D]) and anxiety (Sympto m Checklist [SCL-90]). Multiple regression equations assessed the independe nt contribution of each predictor on depression and anxiety. RESULTS - For both ethnic groups, education, functional impact, and financi al stress significantly and independently predicted depression; poor spouse conflict resolution was a fourth significant predictor for EA patients onl y. The equations accounted for a high percentage of variance (43-55%). Excl uding education, the same variables predicted anxiety for both ethnic group s. The disease status and family Stress variable groups significantly predi cted outcomes independently. The relationships among these variables an occ urred for all patients, not only for those classified as likely depressed. CONCLUSIONS - The findings suggest the utility of considering many life str esses, not just diabetes alone, that combine to affect depression and anxie ty. We suggest that these effects are experienced cumulatively as general p sychological distress for all patients with diabetes, not just those classi fied as likely depressed. Taken together, the findings emphasize a life-cen tered, patient-focused approach to the treatment of depression, rather than an exclusive disease-related perspective.