Depression and diabetes have been linked in a variety of ways, and the presence of depression in those with diabetes can negatively affect adherence to care recommendations. A sample of 201 participants with Type 2 Diabetes completed a cross-sectional survey that assessed depressive symptoms, adherence, self-efficacy, social support, and personal characteristics. Multiple regression analysis was used to test whether self-efficacy and social support mediate the relationship between depressive symptoms and adherence. The findings suggest complete mediation via self-efficacy and some types of social support. Intervening to bolster self-efficacy and social support may decrease the negative effect of depression on adherence.
AliSStoneMAPetersJL. (2006) The prevalence of co-morbid depression in adults with Type 2 diabetes: A systematic review and meta-analysis. Diabetic Medicine23: 1165–1173.
2.
AndersonRJFreedlandKEClouseRE. (2001) The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care24: 1069–1078.
3.
BanduraA (1994) Self-efficacy. In: RamachandranVS (ed.) Encyclopedia of Human Behavior. New York: Academic Press, pp. 71–81.
4.
BaronRMKennyDA (1986) The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology51: 1173–1182.
5.
Centers for Disease Control and Prevention (CDC) (2011) National Diabetes Fact Sheet: National estimates and general information on diabetes and prediabetes in the United States. Available at: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf (accessed 4 October 2013).
6.
ClarkDABeckATAlfordBA (1999) Scientific Foundations of Cognitive Therapy and Therapy of Depression. New York: John Wiley & Sons.
7.
ComstockGWHelsingKJ (1976) Symptoms of depression in two communities. Psychological Medicine6: 551–563.
DiMatteoMR (2004) Variations in patients’ adherence to medical recommendations: A quantitative review of 50 years of research. Medical Care42: 200–209.
10.
DiMatteoMRLepperHSCroghanTW (2000) Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine160: 2101–2107.
11.
EgedeLENietertPJZhengD (2005) Depression and all-cause and coronary heart disease mortality among adults with and without diabetes. Diabetes Care28: 1339–1345.
12.
FentonWSStoverES (2006) Mood disorders: Cardiovascular and diabetes comorbidity. Current Opinion in Psychiatry19: 421–427.
13.
FortmannALGalloLCPhilis-TsimikasA (2011) Glycemic control among Latinos with type 2 diabetes: The role of social-environmental support resources. Health Psychology30: 251–258.
14.
GlasgowREToobertDJ (1988) Social environment and regimen adherence in type II diabetic patients. Diabetes Care11: 377–386.
15.
GonzalezJSPeyrotMMcCarlLA. (2008a) Depression and diabetes treatment nonadherence: A meta-analysis. Diabetes Care31: 2398–2403.
16.
GonzalezJSSafrenSADelahantyLM. (2008b) Symptoms of depression prospectively predict poorer self-care in patients with type 2 diabetes. Diabetic Medicine25: 1102–1107.
17.
Gressle-TovarE (2007) Relationships between Psychosocial Factors and Adherence to Diet and Exercise in Adults with Type 2 Diabetes: A Test of a Theoretical Model (Nursing). Galveston, TX: University of Texas Medical Branch at Galveston, 256 pp.
HernandezCA (1997) The development and pilot testing of The Diabetes Activities Questionnaire (TDAQ): An instrument to measure adherence to the diabetes regimen. Applied Nursing Research10: 202–211.
20.
HoltRGPhillipsDWJamesonKA. (2009) The relationship between depression and diabetes mellitus: Findings from the Hertfordshire Cohort Study. Diabetic Medicine26: 641–648.
21.
JerantAKravitzRMoore-HillM. (2008) Depressive symptoms moderated the effect of chronic illness self-management training on self-efficacy. Medical Care46: 523–531.
22.
KalsekarIDMadhavanSSAmonkarMM. (2006) Depression in patients with type 2 diabetes: Impact on adherence to oral hypoglycemic agents. The Annals of Pharmacotherapy40: 605–611.
23.
KatonWJRutterCSimonG. (2005) The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care28: 2668–2672.
24.
LiCFordESZhaoG. (2009) Prevalence and correlates of undiagnosed depression among U.S. adults with diabetes: The Behavioral Risk Factor Surveillance System, 2006. Diabetes Research and Clinical Practice83: 268–279.
25.
LudmanEJPetersonDKatonWJ. (2013) Improving confidence for self care in patients with depression and chronic illnesses. Behavioral Medicine39: 1–6.
26.
LustmanPJClouseRE (2005) Depression in diabetic patients: The relationship between mood and glycemic control. Journal of Diabetes and Its Complications19: 113–122.
27.
OsbornCYEgedeLE (2012) The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: The role of social support. General Hospital Psychiatry34: 249–253.
28.
PanALucasMSunQ. (2010) Bidirectional association between depression and type 2 diabetes mellitus in women. Archives of Internal Medicine170: 1884–1891.
29.
PreacherKJHayesAF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods40: 879–891.
30.
RadloffLS (1977) The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement1: 385–401.
31.
RichardsonLKEgedeLEMuellerM. (2008) Longitudinal effects of depression on glycemic control in veterans with type 2 diabetes. General Hospital Psychiatry30: 509–514.
32.
RubinRRMaYMarreroDG. (2008) Elevated depression symptoms, antidepressant medicine use, and risk of developing diabetes during the diabetes prevention program. Diabetes Care31: 420–426.
33.
SaccoWPYanoverT (2006) Diabetes and depression: The role of social support and medical symptoms. Journal of Behavioral Medicine29: 523–531.
34.
SaccoWPWellsKJFriedmanA. (2007) Adherence, body mass index, and depression in adults with type 2 diabetes: The mediational role of diabetes symptoms and self-efficacy. Health Psychology26: 693–700.
35.
SaccoWPWellsKJVaughanCA. (2005) Depression in adults with type 2 diabetes: The role of adherence, body mass index, and self-efficacy. Health Psychology24: 630–634.
36.
SarkarUFisherLSchillingerD (2006) Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy?Diabetes Care29: 823–829.
37.
SchwartzAJ (2005) Perceived Social Support and Self-Management of Diabetes among Adults 40 Years and Over. Oxford, OH: Miami University.
38.
ShrivastavaSShrivastavaPRamasamyJ (2013) Role of self-care in management of diabetes mellitus. Journal of Diabetes and Metabolic Disorders12(1): 14.
39.
SobelME (1982) Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology13: 290–312.
40.
SoskolneVCinamonTHeymannA (2011) Family support as a significant factor in facilitating adherence to diabetes self-care and glycemic control. In: Society for Social Work and Research 15th annual conference: Emerging horizons for Social Work Research, Tampa, FL, 15January.
41.
TalbotFNouwenAGingrasJ. (1997) The assessment of diabetes related cognitive and social factors: The Multidimensional Diabetes Questionnaire. Journal of Behavioral Medicine20: 291–312.
42.
ToljamoMHentinenM (2001) Adherence to self-care and social support. Journal of Clinical Nursing10: 618–627.
43.
WagnerJLaceyKChyunD. (2005) Development of a patient questionnaire to measure heart disease risk knowledge in people with diabetes: The Heart Disease Fact Questionnaire. Patient Education and Counseling58: 82–87.
44.
WhittemoreRMelkusGEGreyM (2005) Metabolic control, self-management and psychosocial adjustment in women with type 2 diabetes. Journal of Clinical Nursing14: 195–203.
