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International Journal of Behavioral Medicine

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01-03-2013

Pain and Functional Impairment as Mediators of the Link between Medical Symptoms and Depression in Type 2 Diabetes

Authors: William P. Sacco, Cathy A. Bykowski, Laura L. Mayhew

Published in: International Journal of Behavioral Medicine | Issue 1/2013

Abstract

Background

Among people with diabetes, depression is more common and is associated with greater morbidity and mortality. A better understanding of mechanisms underlying the link between poor health and depression is needed. Pain and functional impairment may account for the effect of poor health on depression in diabetes.

Purpose

The purpose of the study was to examine whether pain and functional impairment mediate the association between diabetes-related medical symptoms and depression in type 2 diabetes.

Method

Adults diagnosed with type 2 diabetes (N = 77) completed the following measures: Patient Health Questionnaire (PHQ), Diabetes Symptom Checklist (DSC), and Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Body mass index (BMI) was computed using height and weight data from medical records. Mediation and linear regression analyses were conducted.

Results

Pain and functional impairment made significant, independent contributions to depression. Functional impairment mediated the link between diabetes-related medical symptoms and depression. Pain mediated the association between higher BMI and depression.

Conclusion

Pain and functional impairment appear to play important, independent roles in depression in type 2 diabetes. Mediation analyses suggest the following: 1. diabetes-related medical problems increase functional impairment, which in turn leads to greater depression; and 2. the burden of carrying greater body mass (higher BMI) increases pain, which leads to increased depression.

Hemoglobin A1c (A1c) measures the average blood glucose level during the previous 60–90 days [55].

For the present investigation, depression is conceptualized as a continuous distribution of depressive symptoms rather than as a diagnostic category.

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Title: Pain and Functional Impairment as Mediators of the Link between Medical Symptoms and Depression in Type 2 Diabetes
Authors: William P. Sacco
Cathy A. Bykowski
Laura L. Mayhew
Publication date: 01-03-2013
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 1/2013
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-011-9210-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pain and Functional Impairment as Mediators of the Link between Medical Symptoms and Depression in Type 2 Diabetes

Abstract

Background

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Method

Results

Conclusion

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