Unit:
Κατεύθυνση Διασυνδετική Ψυχιατρική και Απαρτιωμένη Φροντίδα Σωματικής και Ψυχικής ΥγείαςLibrary of the School of Health Sciences
Author:
Antoniou Anastasia
Supervisors info:
Παναγιώτης Φερεντίνος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ρωσσέτος Γουρνέλλης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αθανάσιος Ράπτης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η γλυκοζυλιωμένη αιμοσφαιρίνη και το B.M.I ως προβλεπτικοί παράγοντες της ευεξίας ασθενών με Σακχαρώδη Διαβήτη Tύπου 2 χωρίς γνωστό ψυχιατρικό ιστορικό: ο διαμεσολαβητικός ρόλος του άγχους και της κατάθλιψης
Translated title:
Glycemic control and BMI predict well-being in Type 2 diabetic patients with no known psychiatric history: the mediating role of anxiety and depression
Summary:
Introduction: Type 2 Diabetes Mellitus (T2DM) is a common metabolic disorder with various medical and psychological complications. The aim of the present study was to investigate the predictors of well-being in T2DM patients with no known psychiatric history and the mediating role of anxiety and depression.
Methods: We recruited 175 T2DM patients (54.3% males, aged 34–79 (mean 59.9) years) followed-up in a General Hospital’s Diabetes Center. Patients included had no severe diabetes-related complications or known psychiatric history. Well-being was measured with the novel 14-item tool Mental Health Continuum Short-Form (MHC-SF), which measures 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 anxiety (HADS-A) and depression (HADS-D). The effects of glycated hemoglobin (HbA1c), Body Mass Index (B.M.I), anxiety and depression on well-being were examined with multiple linear regressions, including sample’s demographic characteristics, T2DM’s duration, type of medication and comorbid hypertension and dyslipidemia as covariates. Structural equation models were created for the examination of the mediatory role of HADS-A and HADS-D in the effects of significant predictors on well-being and its dimensions.
Results: 21.1% of participants had comorbid depression (HADS-D≥11) and 5.1% comorbid anxiety disorder (HADS-A≥11). WBT as well as EWB and PWB were significantly predicted by HbA1c (p=0.001) and BMI (p<0.05) in the models without HADS. 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 structural equation models, the indirect effects of HbA1c and B.M.I 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 B.M.I on EWB, PWB and WBT were completely mediated by HADS-D.
Conclusions: This is the first study using MHC-SF to measure well-being in T2DM patients. High levels of undiagnosed depression were recorded, in agreement with other studies. Depression was predicted by HbA1c and BMI and finally predicted well-being. Depressive symptoms completely mediated the relationship between HbA1c and B.M.I with well-being. Therefore, 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.
Main subject category:
Health Sciences
Keywords:
Anxiety, Depression, Diabetes mellitus type 2, MHC-SF, Well-being
