Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Study Population
2.2. Case–Control Design
2.3. Study Variables
- (1)
- The self-reported presence of a “mental disorder” was defined as the person interviewed reporting depression and/or anxiety, with these conditions being diagnosed by a medical doctor.
- (2)
- (3)
- The variable “consumption of psychiatric medications” was created using questions regarding the self-reported use of physician-prescribed medications in the last two weeks. We considered psychiatric medications as any of the following: “tranquilizers (anxiolytics),” “sedatives (anxiolytics),” “sleeping pills (anxiolytics),” and/or “antidepressants”. In Spain, the terms “tranquilizers” and “sedatives” are used indistinctly by people from outside the healthcare industry to refer to anxiolytics.
2.4. Statistical Analysis
2.5. Ethical Aspects
3. Results
4. Discussion
4.1. Main Findings
4.2. Factors Associated with Mental Disorders, Psychological Distress (GHQ-12 ≥ 3), and Consumption of Psychiatric Medications
4.3. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- De Jonge, P.; Alonso, J.; Stein, D.J.; Kiejna, A.; Aguilar-Gaxiola, S.; Viana, M.C.; Liu, Z.; O’Neill, S.; Bruffaerts, R.; Caldas-De-Almeida, J.M.; et al. Associations between DSM-IV mental disorders and diabetes mellitus: A role for impulse control disorders and depression. Diabetologia 2014, 57, 699–709. [Google Scholar] [CrossRef] [PubMed]
- Huang, C.-J.; Chiu, H.-C.; Lee, M.-H.; Wang, S.-Y. Prevalence and incidence of anxiety disorders in diabetic patients: A national population-based cohort study. Gen. Hosp. Psychiatry 2011, 33, 8–15. [Google Scholar] [CrossRef] [PubMed]
- Fisher, L.; Skaff, M.M.; Mullan, J.T.; Arean, P.; Glasgow, R.; Masharani, U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetes. Diabet. Med. 2008, 25, 1096–1101. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Smith, K.J.; Deschênes, S.S.; Schmitz, N. Investigating the longitudinal association between diabetes and anxiety: A systematic review and meta-analysis. Diabet. Med. 2018, 35, 677–693. [Google Scholar] [CrossRef] [Green Version]
- Lin, E.H.; Von Korff, M.; Alonso, J.; Angermeyer, M.C.; Anthony, J.; Bromet, E.; Bruffaerts, R.; Gasquet, I.; de Girolamo, G.; Gureje, O.; et al. Mental disorders among persons with diabetes—Results from the World Mental Health Surveys. J. Psychosom. Res. 2008, 65, 571–580. [Google Scholar] [CrossRef] [Green Version]
- Das-Munshi, J.; Stewart, R.; Ismail, K.; Bebbington, P.E.; Jenkins, R.; Prince, M. Diabetes, Common Mental Disorders, and Disability: Findings from the UK National Psychiatric Morbidity Survey. Psychosom. Med. 2007, 69, 543–550. [Google Scholar] [CrossRef]
- DiMatteo, M.R.; Lepper, H.S.; Croghan, T.W. Depression Is a Risk Factor for Noncompliance with Medical Treatment. Arch. Intern. Med. 2000, 160, 2101–2107. [Google Scholar] [CrossRef]
- Anderson, R.J.; Grigsby, A.B.; Freedland, K.E.; De Groot, M.; McGill, J.B.; Clouse, R.E.; Lustman, P.J. Anxiety and poor glycemic control: A meta-analytic review of the literature. Int. J. Psychiatry Med. 2002, 32, 235–247. [Google Scholar] [CrossRef]
- De Alba, I.G.F.; Gimeno-Miguel, A.; Poblador-Plou, B.; Gimeno-Feliu, L.A.; Ioakeim-Skoufa, I.; Rojo-Martínez, G.; Forjaz, M.J.; Prados-Torres, A. Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients. Sci. Rep. 2020, 10, 19583. [Google Scholar] [CrossRef]
- Roy, T.; Lloyd, C.E. Epidemiology of depression and diabetes: A systematic review. J. Affect. Disord. 2012, 142, S8–S21. [Google Scholar] [CrossRef]
- Deschênes, S.S.; Burns, R.J.; Schmitz, N. Comorbid depressive and anxiety symptoms and the risk of type 2 diabetes: Findings from the Lifelines Cohort Study. J. Affect. Disord. 2018, 238, 24–31. [Google Scholar] [CrossRef]
- Gómez-Pimienta, E.; González-Castro, T.B.; Fresan, A.; Juárez-Rojop, I.E.; Martínez-López, M.C.; Barjau-Madrigal, H.A.; Ramírez-González, I.R.; Martínez-Villaseñor, E.; Rodríguez-Sánchez, E.; Villar-Soto, M.; et al. Decreased Quality of Life in Individuals with Type 2 Diabetes Mellitus Is Associated with Emotional Distress. Int. J. Environ. Res. Public Health 2019, 16, 2652. [Google Scholar] [CrossRef] [Green Version]
- Chen, J.; Huang, X.-F.; Shao, R.; Chen, C.; Deng, C. Molecular Mechanisms of Antipsychotic Drug-Induced Diabetes. Front. Neurosci. 2017, 11, 643. [Google Scholar] [CrossRef]
- Keating, P.; O’Connor, R.; O’Doherty, J.; Hannigan, A.; Cullen, W.; Hickey, L.; Harnett, A.; Meagher, D.; O’Regan, A. Prescription of psychotropic medication in patients with type two diabetes mellitus: A multi-practice study from Ireland. Eur. J. Gen. Pract. 2019, 25, 157–163. [Google Scholar] [CrossRef] [Green Version]
- Ducat, L.; Philipson, L.H.; Anderson, B.J. The Mental Health Comorbidities of Diabetes. JAMA 2014, 312, 691–692. [Google Scholar] [CrossRef]
- Boden, M.T. Prevalence of mental disorders and related functioning and treatment engagement among people with diabetes. J. Psychosom. Res. 2018, 106, 62–69. [Google Scholar] [CrossRef]
- Fisher, L.; Skaff, M.M.; Mullan, J.T.; Arean, P.; Mohr, D.; Masharani, U.; Glasgow, R.; Laurencin, G. Clinical Depression Versus Distress Among Patients With Type 2 Diabetes: Not just a question of semantics. Diabetes Care 2007, 30, 542–548. [Google Scholar] [CrossRef] [Green Version]
- Dennick, K.; Sturt, J.; Speight, J. What is diabetes distress and how can we measure it? A narrative review and conceptual model. J. Diabetes Complicat. 2017, 31, 898–911. [Google Scholar] [CrossRef] [Green Version]
- Chaturvedi, S.K.; Gowda, S.M.; Ahmed, H.U.; Alosaimi, F.D.; Andreone, N.; Bobrov, A.; Bulgari, V.; Carrà, G.; Castelnuovo, G.; De Girolamo, G.; et al. More anxious than depressed: Prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus. Gen. Psychiatry 2019, 32, e100076. [Google Scholar] [CrossRef] [Green Version]
- Garcia, R.J.; Huedo, M.A.M.; Hernandez-Barrera, V.; De Andrés, A.L.; Martinez, D.; Jiménez-Trujillo, I.; Carrasco-Garrido, P.; Jiménez-García, R.; Hernandez-Barrera, V. Psychological distress and mental disorders among Spanish diabetic adults: A case–control study. Prim. Care Diabetes 2012, 6, 149–156. [Google Scholar] [CrossRef]
- Instituto Nacional de Estadistica. Encuesta Nacional de Salud 2017. [National Health Survey 2017, Methodology]. Available online: https://www.ine.es/en/metodologia/t15/t153041917_en.pdf (accessed on 12 February 2021).
- Instituto Nacional de Estadistica. Encuesta Nacional de Salud 2017 Cuestinario de Adultos [National Health Survey 2017. Adults Questionnaire]. Available online: https://www.ine.es/metodologia/t15/ense_adu17.pdf (accessed on 11 March 2021).
- Soriguer, F.; Goday, A.; Bosch-Comas, A.; Bordiú, E.; Calle-Pascual, A.; Carmena, R.; Casamitjana, R.; Castaño, L.; Castell, C.; Catalá, M.; et al. Prevalence of diabetes mellitus and impaired glucose regulation in Spain: The [email protected] Study. Diabetologia 2012, 55, 88–93. [Google Scholar] [CrossRef] [Green Version]
- Muñóz, P.E.; Vázquez, J.L.; Rodríguez Insausti, F.; Pastrana, E.; Varo, J. Adaptación española del General Health Questionnaire (G.H.Q.) de D. P. Goldberg (un método de identificación de casos psiquiátricos en la comunidad [Spanish adaptation of the General Health Questionnaire (G.H.Q.) of D. P. Goldberg (a method for identifying psychiatric cases in the community)]. Arch. Neurobiol. 1979, 42, 139–158. [Google Scholar]
- Sánchez-López, M.d.P.; Dresch, V. The 12-Item General Health Questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population. Psicothema 2008, 20, 839–843. [Google Scholar]
- Sakai, R.; Hashimoto, Y.; Hamaguchi, M.; Ushigome, E.; Okamura, T.; Majima, S.; Asano, M.; Yamazaki, M.; Fukui, M. Living alone is associated with visit-to-visit HbA1c variability in men but not in women in people with type 2 diabetes: KAMOGAWA-DM cohort study. Endocr. J. 2020, 67, 419–426. [Google Scholar] [CrossRef] [Green Version]
- Whisman, M.A.; Li, A.; Sbarra, D.A.; Raison, C.L. Marital quality and diabetes: Results from the Health and Retirement Study. Health Psychol. 2014, 33, 832–840. [Google Scholar] [CrossRef]
- Brinkhues, S.; Dukers-Muijrers, N.H.; Hoebe, C.J.; Van Der Kallen, C.J.; Koster, A.; Henry, R.M.; Stehouwer, C.D.; Savelkoul, P.H.; Schaper, N.; Schram, M.T. Social Network Characteristics Are Associated With Type 2 Diabetes Complications: The Maastricht Study. Diabetes Care 2018, 41, 1654–1662. [Google Scholar] [CrossRef] [Green Version]
- Hosmer, J.; Lemeshow, S.; Sturdivant, R.X. Applied Logistic Regression, 3rd ed.; John Wiley & Sons, Ltd.: Hoboken, NJ, USA, 2013. [Google Scholar]
- Ministerio de Sanidad Consumo y Bienestar Social. Encuesta Nacional de Salud 2017 Microdatos. [National Health Survey 2017. Microdata]. Available online: https://www.mscbs.gob.es/estadisticas/microdatos.do (accessed on 18 February 2021).
- Volkert, J.; Schulz, H.; Härter, M.; Wlodarczyk, O.; Andreas, S. The prevalence of mental disorders in older people in Western countries—A meta-analysis. Ageing Res. Rev. 2013, 12, 339–353. [Google Scholar] [CrossRef]
- Undén, A.-L.; Elofsson, S.; Andréasson, A.; Hillered, E.; Eriksson, I.; Brismar, K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend. Med. 2008, 5, 162–180. [Google Scholar] [CrossRef]
- Brieler, J.A.; Lustman, P.J.; Scherrer, J.F.; Salas, J.; Schneider, F.D. Antidepressant medication use and glycaemic control in co-morbid type 2 diabetes and depression. Fam. Pract. 2016, 33, 30–36. [Google Scholar] [CrossRef] [Green Version]
- Maust, D.T.; Blow, F.C.; Wiechers, I.R.; Kales, H.C.; Marcus, S.C. National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care. J. Clin. Psychiatry 2017, 78, e363–e371. [Google Scholar] [CrossRef]
- Tobin, H.; Bury, G.; Cullen, W. Mental illness in primary care: A narrative review of patient, GP and population factors that affect prescribing rates. Ir. J. Psychol. Med. 2020, 37, 59–66. [Google Scholar] [CrossRef] [PubMed]
- Fisher, L.; Glasgow, R.E.; Strycker, L.A. The Relationship Between Diabetes Distress and Clinical Depression With Glycemic Control Among Patients With Type 2 Diabetes. Diabetes Care 2010, 33, 1034–1036. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zhao, W.; Chen, Y.; Lin, M.; Sigal, R. Association between diabetes and depression: Sex and age differences. Public Health 2006, 120, 696–704. [Google Scholar] [CrossRef] [PubMed]
- Collins, M.M.; Corcoran, P.; Perry, I.J. Anxiety and depression symptoms in patients with diabetes. Diabet. Med. 2009, 26, 153–161. [Google Scholar] [CrossRef]
- Schieman, S.; Van Gundy, K.; Taylor, J. The relationship between age and depressive symptoms: A test of competing explanatory and suppression influences. J. Aging Health 2002, 14, 260–285. [Google Scholar] [CrossRef]
- Carrasco-Garrido, P.; Garcia, R.J.; Astasio-Arbiza, P.; Ortega-Molina, P.; Gil De Miguel, A. Psychotropics use in the Spanish elderly: Predictors and evolution between years 1993 and 2003. Pharmacoepidemiol. Drug Saf. 2007, 16, 449–457. [Google Scholar] [CrossRef]
- Ouk, M.; Wu, C.-Y.; Colby-Milley, J.; Fang, J.; Zhou, L.; Shah, B.R.; Herrmann, N.; Lanctôt, K.L.; Linkewich, E.; Law, M.; et al. Depression and Diabetes Mellitus Multimorbidity Is Associated with Loss of Independence and Dementia Poststroke. Stroke 2020, 51, 3531–3540. [Google Scholar] [CrossRef]
- Carrasco-Garrido, P.; Hernández-Barrera, V.; Jiménez-Trujillo, I.; Esteban-Hernández, J.; Álvaro-Meca, A.; Andrés, A.L.-D.; DelBarrio-Fernández, J.L.; Garcia, R.J. Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study. Int. J. Environ. Res. Public Health 2016, 13, 1177. [Google Scholar] [CrossRef]
- Semenkovich, K.; Brown, M.E.; Svrakic, D.M.; Lustman, P.J. Depression in Type 2 Diabetes Mellitus: Prevalence, Impact, and Treatment. Drugs 2015, 75, 577–587. [Google Scholar] [CrossRef]
- Feng, X.; Astell-Burt, T. Impact of a type 2 diabetes diagnosis on mental health, quality of life, and social contacts: A longitudinal study. BMJ Open Diabetes Res. Care 2017, 5, e000198. [Google Scholar] [CrossRef] [Green Version]
- McCoy, M.A.; Theeke, L.A. A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus. Int. J. Nurs. Sci. 2019, 6, 468–477. [Google Scholar] [CrossRef]
- Holt-Lunstad, J.; Smith, T.B.; Baker, M.; Harris, T.; Stephenson, D. Loneliness and Social Isolation as Risk Factors for Mortality: A meta-analytic review. Perspect. Psychol. Sci. 2015, 10, 227–237. [Google Scholar] [CrossRef] [Green Version]
- International Diabetes Federation. IDF Clinical Practice Recommendations for Managing Type 2 Diabetes in Primary Care. 2018. Available online: https://www.idf.org/e-library/guidelines/128-idf-clinical-practice-recommendations-for-managing-type-2-diabetes-in-primary-care.html (accessed on 7 March 2021).
- American Diabetes Association 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes—2020. Diabetes Care 2020, 43, S37–S47. [Google Scholar] [CrossRef] [Green Version]
- Castellano-Guerrero, A.M.; Guerrero, R.; Relimpio, F.; Losada, F.; Mangas, M.A.; Pumar, A.; Martínez-Brocca, M.A. Prevalence and predictors of depression and anxiety in adult patients with type 1 diabetes in tertiary care setting. Acta Diabetol. 2018, 55, 943–953. [Google Scholar] [CrossRef]
- Shevlin, M.; Adamson, G. Alternative Factor Models and Factorial Invariance of the GHQ-12: A Large Sample Analysis Using Confirmatory Factor Analysis. Psychol. Assess. 2005, 17, 231–236. [Google Scholar] [CrossRef]
- Arroyo, E.; Cabrera-León, A.; Renart, G.; Saurina, C.; Saurina, L.S.; Daponte, A.; Saez, M. Did psychotropic drug consumption increase during the 2008 financial crisis? A cross-sectional population-based study in Spain. BMJ Open 2019, 9, e021440. [Google Scholar] [CrossRef] [Green Version]
- Henares-Montiel, J.; Ruiz-Pérez, I.; Sordo, L. Salud mental en España y diferencias por sexo y por comunidades autónomas [Mental health in Spain and differences by sex, and by autonomous communities]. Gac. Sanit. 2020, 34, 114–119. [Google Scholar] [CrossRef]
- Garriga, C.; Trujillo, L.G.; Del Romero, J.; Montero, M.; Pérez-Elías, M.J.; Lévano, D.C.; Gutierrez, F.; Gómez-Sirvent, J.L.; Peña-Monje, A.; Blanco, J.R.; et al. Psychological distress in women and men living with HIV in Spain: A cross-sectional telephone survey. Évid. Based Ment. Health 2020, 23, 91–99. [Google Scholar] [CrossRef]
- Huerta, J.M.; Tormo, M.J.; Egea-Caparrós, J.M.; Ortolá-Devesa, J.B.; Navarro, C. Accuracy of self-reported diabetes, hypertension and hyperlipidemia in the adult Spanish population. DINO study findings. Rev. Esp. Cardiol. 2009, 62, 143–152. [Google Scholar] [CrossRef]
Health Variables | Categories | DM | Non-DM | |||
---|---|---|---|---|---|---|
n | % | n | % | p | ||
Self-rated health | Very good/good | 69 | 9.7 | 88 | 7.9 | 0.195 |
Fair/poor/very poor | 460 | 32.7 | 319 | 31.6 | 0.557 | |
Emergency services in last year | Yes | 266 | 32.8 | 154 | 25.9 | 0.005 |
No | 263 | 20.1 | 253 | 16.6 | 0.016 | |
Hospital admission in last year | Yes | 105 | 27.9 | 75 | 28.3 | 0.917 |
No | 424 | 24.3 | 332 | 17.9 | <0.001 | |
Visit to psychologist in last year | Yes | 92 | 83.6 | 89 | 84.0 | 0.948 |
No | 437 | 21.8 | 317 | 15.8 | <0.001 | |
Hypertension | Yes | 369 | 26.5 | 200 | 21.7 | 0.008 |
No | 160 | 22.1 | 207 | 17.3 | 0.010 | |
Heart diseases | Yes | 180 | 31.0 | 91 | 24.1 | 0.019 |
No | 349 | 22.7 | 316 | 18.2 | 0.001 | |
Arthrosis | Yes | 342 | 33.7 | 243 | 28.4 | 0.013 |
No | 187 | 17.0 | 164 | 13.0 | 0.007 | |
Stroke | Yes | 55 | 38.7 | 21 | 29.6 | 0.189 |
No | 474 | 24.0 | 386 | 18.9 | <0.001 | |
Respiratory disease | Yes | 146 | 40.9 | 80 | 32.0 | 0.026 |
No | 383 | 21.7 | 327 | 17.5 | 0.001 | |
Malignant tumor | Yes | 71 | 37.2 | 49 | 27.2 | 0.041 |
No | 458 | 23.8 | 358 | 18.5 | <0.001 | |
Chronic pain | Yes | 346 | 35.0 | 260 | 29.3 | 0.008 |
No | 183 | 16.2 | 147 | 11.9 | 0.003 | |
Accident with permanent injuries | Yes | 63 | 35.0 | 49 | 32.2 | 0.596 |
No | 466 | 24.0 | 358 | 18.2 | <0.001 | |
Obesity | Yes | 171 | 25.9 | 89 | 23.0 | 0.299 |
No | 313 | 24.0 | 280 | 17.6 | <0.001 | |
Alcohol consumption in last 12 months | Yes | 175 | 17.0 | 159 | 13.1 | 0.010 |
No | 354 | 32.5 | 248 | 27.4 | 0.013 | |
Current smoking habit | Yes | 82 | 25.5 | 64 | 18.8 | 0.039 |
No | 447 | 24.9 | 343 | 19.3 | <0.001 | |
Physical inactivity | Yes | 325 | 31.5 | 220 | 25.8 | 0.007 |
No | 204 | 18.8 | 187 | 14.8 | 0.009 |
Health Variables | Categories | DM | Non-DM | |||
---|---|---|---|---|---|---|
n | % | n | % | p | ||
Self-rated health | Very good/good | 81 | 11.4 | 85 | 7.7 | 0.007 |
Fair/poor/very poor | 522 | 38.1 | 320 | 32.8 | 0.008 | |
Emergency services in last year | Yes | 322 | 40.9 | 176 | 30.7 | <0.001 |
No | 281 | 21.8 | 229 | 15.2 | <0.001 | |
Hospital admission in last year | Yes | 149 | 41.0 | 81 | 32.0 | 0.023 |
No | 454 | 26.5 | 324 | 17.7 | <0.001 | |
Visit to psychologist in last year | Yes | 74 | 71.8 | 67 | 65.7 | 0.341 |
No | 529 | 26.8 | 338 | 17.1 | <0.001 | |
Hypertension | Yes | 420 | 30.7 | 198 | 21.9 | <0.001 |
No | 183 | 25.7 | 207 | 17.6 | <0.001 | |
Heart disease | Yes | 217 | 38.3 | 94 | 25.7 | <0.001 |
No | 386 | 25.5 | 311 | 18.1 | <0.001 | |
Arthrosis | Yes | 378 | 38.3 | 222 | 26.4 | <0.001 |
No | 225 | 20.6 | 183 | 14.8 | <0.001 | |
Stroke | Yes | 68 | 48.9 | 20 | 32.3 | 0.032 |
No | 535 | 27.6 | 385 | 19.1 | <0.001 | |
Respiratory disease | Yes | 137 | 39.6 | 83 | 34.6 | 0.218 |
No | 466 | 26.9 | 322 | 17.5 | <0.001 | |
Malignant tumors | Yes | 82 | 44.3 | 51 | 29.3 | 0.003 |
No | 521 | 27.5 | 354 | 18.6 | <0.001 | |
Chronic pain | Yes | 377 | 38.8 | 242 | 27.6 | <0.001 |
No | 226 | 20.4 | 163 | 13.5 | <0.001 | |
Accident with permanent injuries | Yes | 63 | 36.2 | 49 | 33.8 | 0.653 |
No | 540 | 28.3 | 356 | 18.4 | <0.001 | |
Obesity | Yes | 209 | 32.2 | 85 | 22.2 | <0.001 |
No | 343 | 26.6 | 291 | 18.6 | 0.001 | |
Alcohol consumption in last 12 months | Yes | 212 | 20.8 | 171 | 14.2 | <0.001 |
No | 391 | 37.0 | 234 | 26.7 | <0.001 | |
Current smoking habit | Yes | 95 | 29.6 | 61 | 18.0 | <0.001 |
No | 508 | 28.9 | 344 | 19.8 | <0.001 | |
Physical inactivity | Yes | 402 | 40.1 | 245 | 29.7 | <0.001 |
No | 200 | 18.6 | 160 | 12.7 | <0.001 |
Health Variables | Categories | DM | Non-DM | |||
---|---|---|---|---|---|---|
n | % | n | % | p | ||
Self-rated health | Very good/good | 73 | 10.3 | 107 | 9.7 | 0.678 |
Fair/poor/very poor | 557 | 39.6 | 392 | 38.8 | 0.686 | |
Emergency services in last year | Yes | 334 | 41.2 | 201 | 33.8 | 0.005 |
No | 296 | 22.6 | 298 | 19.5 | 0.044 | |
Hospital admission in last year | Yes | 146 | 38.8 | 89 | 33.6 | 0.175 |
No | 484 | 27.8 | 410 | 22.1 | <0.001 | |
Visit to psychologist in last year | Yes | 90 | 81.8 | 91 | 85.8 | 0.422 |
No | 540 | 26.9 | 408 | 20.3 | <0.001 | |
Hypertension | Yes | 467 | 33.5 | 269 | 29.1 | 0.027 |
No | 163 | 22.5 | 230 | 19.2 | 0.087 | |
Heart disease | Yes | 236 | 40.6 | 133 | 35.2 | 0.091 |
No | 394 | 25.6 | 366 | 21.0 | 0.002 | |
Arthrosis | Yes | 431 | 42.4 | 318 | 37.1 | 0.018 |
No | 199 | 18.0 | 181 | 14.4 | 0.015 | |
Stroke | Yes | 67 | 47.2 | 32 | 45.1 | 0.771 |
No | 563 | 28.5 | 467 | 22.8 | <0.001 | |
Respiratory disease | Yes | 153 | 42.9 | 88 | 35.2 | 0.058 |
No | 477 | 27.1 | 411 | 22.0 | <0.001 | |
Malignant tumors | Yes | 80 | 41.9 | 57 | 31.5 | 0.038 |
No | 550 | 28.5 | 442 | 22.8 | <0.001 | |
Chronic pain | Yes | 417 | 42.2 | 312 | 35.1 | 0.002 |
No | 67 | 47.2 | 32 | 45.1 | 0.771 | |
Accident with permanent injuries | Yes | 64 | 35.6 | 50 | 32.9 | 0.611 |
No | 566 | 29.2 | 449 | 22.8 | <0.001 | |
Obesity | Yes | 206 | 31.1 | 99 | 25.6 | 0.057 |
No | 356 | 27.3 | 353 | 22.1 | 0.001 | |
Alcohol consumption in last 12 months | Yes | 216 | 21.0 | 195 | 16.1 | 0.003 |
No | 414 | 38.0 | 304 | 33.5 | 0.038 | |
Current smoking habit | Yes | 78 | 24.2 | 62 | 18.2 | 0.059 |
No | 552 | 30.7 | 437 | 24.6 | <0.001 | |
Physical inactivity | Yes | 395 | 38.3 | 274 | 32.2 | 0.006 |
No | 235 | 21.7 | 225 | 17.8 | 0.017 | |
Mental disorders | Yes | 385 | 72.8 | 292 | 71.7 | 0.726 |
No | 244 | 15.4 | 206 | 12.0 | 0.006 | |
Psychological distress (GHQ-12 ≥ 3) | Yes | 324 | 53.7 | 209 | 51.6 | 0.507 |
No | 285 | 19.3 | 267 | 15.9 | 0.013 |
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Lopez-Herranz, M.; Jiménez-García, R.; Ji, Z.; de Miguel-Diez, J.; Carabantes-Alarcon, D.; Maestre-Miquel, C.; Zamorano-León, J.J.; López-de-Andrés, A. Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study. Int. J. Environ. Res. Public Health 2021, 18, 6088. https://doi.org/10.3390/ijerph18116088
Lopez-Herranz M, Jiménez-García R, Ji Z, de Miguel-Diez J, Carabantes-Alarcon D, Maestre-Miquel C, Zamorano-León JJ, López-de-Andrés A. Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study. International Journal of Environmental Research and Public Health. 2021; 18(11):6088. https://doi.org/10.3390/ijerph18116088
Chicago/Turabian StyleLopez-Herranz, Marta, Rodrigo Jiménez-García, Zichen Ji, Javier de Miguel-Diez, David Carabantes-Alarcon, Clara Maestre-Miquel, José J. Zamorano-León, and Ana López-de-Andrés. 2021. "Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study" International Journal of Environmental Research and Public Health 18, no. 11: 6088. https://doi.org/10.3390/ijerph18116088