Comparative study of the influence of diabetes distress and depression on treatment adherence in Chinese patients with type 2 diabetes: a cross-sectional survey in the People’s Republic of China

• Main Authors: Zhang J, Xu CP, Wu HX, Xue XJ, Xu ZJ, Li Y, Gao Q, Liu QZ
• Format: Article
• Language: English
• Published: Dove Medical Press 2013-09-01
• Series: Neuropsychiatric Disease and Treatment
• Online Access: http://www.dovepress.com/comparative-study-of-the-influence-of-diabetes-distress-and-depression-a14236

Jie Zhang,1 Cui-ping Xu,2 Hong-xia Wu,2 Xiu-juan Xue,2 Ze-jun Xu,3 Yan Li,4 Qing Gao,2 Qing-zhi Liu5 1Shandong Medical College, Jinan, People&rsquo;s Republic of China; 2Qianfoshan Hospital, Shandong University, Jinan, Shandong, People&rsquo;s Republic of China; 3Sichuan Provincial People&rsquo;s Hospital, Chengdu, Sichuan, People&rsquo;s Republic of China; 4Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People&rsquo;s Republic of China; 5QiLu Hospital, Shandong University, Jinan, Shandong, People&rsquo;s Republic of China Background: The purpose of this study was to explore diabetes-related distress and depression and their influence on treatment adherence in Chinese patients with type 2 diabetes. Methods: We surveyed 200 type 2 diabetic patients from two public hospitals using the Diabetes Distress Scale (DDS), Zung Self-rating Depression Scale, and Revised Treatment Adherence in Diabetes Questionnaire (RADQ). A multiple regression model was used to explore the relationship between diabetes distress, depression, and treatment adherence. Results: In the 200 eligible patients, the incidence of depression and diabetes distress was approximately 24% and 64%, respectively. The mean score on the RADQ was 23.0 &plusmn; 6.0. Multiple regression analysis showed that DDS scores (&beta; = 5.34, P = 0.000), age (&beta; = 0.15, P = 0.014), and family history (&beta; = 3.2, P = 0.016) had a positive correlation with depression. DDS scores (&beta; = &minus;2.30, P = 0.000) and treatment methods (&beta; = &minus;0.93, P = 0.012) were risk factors for poor treatment adherence, whereas age (&beta; = 0.089, P = 0.000) and cohabitation (&beta; = 0.93, P = 0.012) increased treatment adherence. The independent-samples t-test showed that depression also affected treatment adherence (t = 2.53, P < 0.05). Conclusion: These findings suggest that the DDS is a predictor of depression and that diabetes distress plays a more important part than depression in treatment adherence. Screening for diabetes distress may be useful for primary prevention of psychologic problems; however, some form of specialized psychologic intervention should be incorporated to promote patient adherence with treatment. Keywords: distress, depression, type 2 diabetes, treatment, adherence, People&rsquo;s Republic of China