PMID- 36436212
OWN - NLM
STAT- MEDLINE
DCOM- 20240101
LR  - 20240106
IS  - 1105-2333 (Print)
IS  - 1105-2333 (Linking)
VI  - 34
IP  - 4
DP  - 2023 Dec 29
TI  - Investigating predictors of well-being in type 2 diabetes mellitus patients: the 
      role of undiagnosed depression.
PG  - 269-278
LID - 10.22365/jpsych.2022.093 [doi]
AB  - Type 2 diabetes mellitus (T2DM) is a common metabolic disorder with various 
      medical and psychological adverse effects. Well-being in patients with T2DM is 
      often compromised. The aim of the present study was to investigate 
      clinicodemographic predictors of well-being in patients with T2DM with no known 
      psychiatric history and explore the mediatory role of undiagnosed anxiety and 
      depression. We recruited 175 outpatients with T2DM (54.3% males, aged 34-79 (mean 
      59.9) years) followed-up at the Diabetes Center of the General Hospital of 
      Nikaia-Peiraeus in Athens. Patients included had no severe diabetes-related 
      complications or known psychiatric history. Well-being was measured with the 
      Mental Health Continuum Short-Form (MHC-SF), a novel 14-item tool measuring the 
      emotional (EWB), social (SWB) and psychological (PWB) dimensions of well-being, 
      as well as a total score of well-being (WBT). Hospital Anxiety and Depression 
      Scale (HADS) was used for screening for undiagnosed anxiety (HADS-A) and 
      depression (HADS-D). Patients' demographics, Body Mass Index (BMI), glycemic 
      control (HbA1c), T2DM duration, comorbid hypertension or dyslipidemia and type of 
      antidiabetic medication were investigated as predictors of well-being or its 
      dimensions in stepwise linear regression models, also including or excluding 
      HADS-A and HADS-D. Mediational effects of HADS-A and HADS-D were explored in 
      structural equation models through path analyses. Results showed that 21.1% of 
      participants had comorbid depression (HADS-D>/=11) and 5.1% comorbid anxiety 
      disorder (HADS-A>/=11). In the models without HADS, higher WBT as well as EWB and 
      PWB were significantly predicted by lower HbA1c (all p=0.001) and lower BMI 
      (p=0.015, 0.019 and 0.030, respectively). After being included in the model, 
      HADS-A and HADS-D significantly predicted WBT and every dimension of well-being, 
      but the effects of HbA1c and BMI were no longer statistically significant. In 
      path analyses, the indirect effects of HbA1c and BMI on well-being via HADS-D 
      were statistically significant, while the direct and indirect effects via HADS-A 
      were not. Therefore, the effects of HbA1c and BMI on EWB, PWB and WBT were 
      completely mediated by HADS-D. Concludingly, this is the first study using MHC-SF 
      to measure well-being in patients with T2DM. High levels of undiagnosed 
      depression were recorded, in agreement with other studies. Depression was 
      predicted by HbA1c and BMI and finally predicted well-being. Undiagnosed 
      depression fully explained the effects of HbA1c and BMI on well-being. The 
      interplay of glycemic control and positive mental health should be further 
      investigated.
FAU - Antoniou, Anastasia
AU  - Antoniou A
AD  - National and Kapodistrian University of Athens (NKUA), 2nd Department of 
      Psychiatry, Attikon General Hospital, Athens, Greece.
FAU - Sotiropoulos, Alexios
AU  - Sotiropoulos A
AD  - General Hospital of Nikaia-Piraeus "Agios Panteleimon", Diabetes Center, Athens, 
      Greece.
FAU - Skliros, Efstathios
AU  - Skliros E
AD  - General Hospital of Nikaia-Piraeus "Agios Panteleimon", Diabetes Center, Athens, 
      Greece.
FAU - Raptis, Athanasios
AU  - Raptis A
AD  - National and Kapodistrian University of Athens (NKUA), 2nd Department of Internal 
      Medicine, Attikon General Hospital, Athens, Greece.
FAU - Gournellis, Rossetos
AU  - Gournellis R
AD  - National and Kapodistrian University of Athens (NKUA), 2nd Department of 
      Psychiatry, Attikon General Hospital, Athens, Greece.
FAU - Rizos, Emmanouil
AU  - Rizos E
AD  - National and Kapodistrian University of Athens (NKUA), 2nd Department of 
      Psychiatry, Attikon General Hospital, Athens, Greece.
FAU - Smyrnis, Nikolaos
AU  - Smyrnis N
AD  - National and Kapodistrian University of Athens (NKUA), 2nd Department of 
      Psychiatry, Attikon General Hospital, Athens, Greece.
FAU - Ferentinos, Panagiotis
AU  - Ferentinos P
AD  - National and Kapodistrian University of Athens (NKUA), 2nd Department of 
      Psychiatry, Attikon General Hospital, Athens, Greece.
LA  - eng
PT  - Journal Article
DEP - 20221111
PL  - Greece
TA  - Psychiatriki
JT  - Psychiatrike = Psychiatriki
JID - 101534363
RN  - 0 (Glycated Hemoglobin)
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - *Diabetes Mellitus, Type 2/complications/diagnosis
MH  - Depression/diagnosis/epidemiology/psychology
MH  - Glycated Hemoglobin
MH  - Comorbidity
MH  - Anxiety/diagnosis/epidemiology/psychology
OTO - NOTNLM
OT  - Anxiety
OT  - BMI
OT  - HADS
OT  - HbA1c
OT  - MHC-SF
OT  - depression
OT  - glycemic control
OT  - type 2 diabetes mellitus
OT  - well-being
EDAT- 2022/11/28 06:00
MHDA- 2024/01/02 11:46
CRDT- 2022/11/27 16:59
PHST- 2024/01/02 11:46 [medline]
PHST- 2022/11/28 06:00 [pubmed]
PHST- 2022/11/27 16:59 [entrez]
AID - 10.22365/jpsych.2022.093 [doi]
PST - ppublish
SO  - Psychiatriki. 2023 Dec 29;34(4):269-278. doi: 10.22365/jpsych.2022.093. Epub 2022 
      Nov 11.