Factors Associated with Depressive Symptoms in Korean Adults with Diabetes Mellitus: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Measurements
2.2.1. Depressive Symptoms
2.2.2. Sociodemographic Characteristics
2.2.3. Health Behavioral Characteristics
2.2.4. Diabetes-Related Characteristics
2.2.5. Outcomes
2.3. Statistical Analysis
3. Results
3.1. Prevalence of Depressive Symptoms
3.2. Differences in Sociodemographic Characteristics with and without Depressive Symptoms
3.3. Differences in Health Behavioral Characteristics with and without Depressive Symptoms
3.4. Differences in Diabetes-Related Characteristics with and without Depressive Symptoms
3.5. Factors Associated with Depressive Symptoms
3.6. Factors Associated with Depressive Symptoms by Sex
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Total | Without Depressive Symptoms (PHQ < 10) | With Depressive Symptoms (PHQ ≥ 10) | p-Value | ||
---|---|---|---|---|---|---|
(n = 1380) | (n = 149) | |||||
n (%) | n | W (%) | n | W (%) | ||
Total | 1529 (100%) | 1380 | 90.4 | 149 | 9.6 | |
Sex | <0.001 | |||||
Male | 749 (52.8) | 699 | 93.9 | 50 | 6.1 | |
Female | 780 (47.2) | 681 | 86.4 | 99 | 13.6 | |
Age (years), Mean ± SD | 63.34 ± 0.68 | 63.04 ± 0.42 | 63.64 ± 1.29 | 0.776 | ||
19–49 | 127 (12.6) | 116 | 90.2 | 11 | 9.8 | |
50–59 | 281 (25.1) | 258 | 92.0 | 23 | 8.0 | |
60–69 | 487 (29.4) | 436 | 89.8 | 51 | 10.2 | |
≥70 | 634 (32.9) | 570 | 89.7 | 64 | 10.3 | |
Educational level (years) | 0.003 | |||||
≤6 (Elementary school) | 665 (38.2) | 578 | 86.5 | 87 | 13.5 | |
7–9 (Middle school) | 260 (16.5) | 237 | 90.8 | 23 | 9.2 | |
10–12 (High school) | 390 (29.1) | 361 | 91.8 | 29 | 8.2 | |
>12 (College and beyond) | 214 (16.2) | 204 | 96.3 | 10 | 3.7 | |
Living area | 0.894 | |||||
Rural | 362 (20.6) | 325 | 90.1 | 37 | 9.9 | |
Urban | 1167 (79.4) | 1055 | 90.4 | 112 | 9.6 | |
Living | <0.001 | |||||
With spouse | 1087 (72.5) | 1006 | 93.3 | 81 | 6.7 | |
Without spouse | 442 (27.5) | 374 | 82.7 | 68 | 17.3 | |
Employment | <0.001 | |||||
Employed | 678 (50.3) | 645 | 95.0 | 33 | 5.0 | |
Unemployed | 851 (49.7) | 735 | 85.7 | 116 | 14.3 | |
Household income | <0.001 | |||||
Low | 436 (29.5) | 368 | 84.5 | 68 | 15.5 | |
Low–medium | 382 (23.6) | 345 | 89.4 | 37 | 10.6 | |
Medium–high | 373 (23.7) | 344 | 93.3 | 29 | 6.7 | |
High | 338 (23.2) | 323 | 95.8 | 15 | 4.2 |
Variables | Total | Without Depressive Symptoms (PHQ < 10) | With Depressive Symptoms (PHQ ≥ 10) | p-Value | ||
---|---|---|---|---|---|---|
(n = 1380) | (n = 149) | |||||
n (%) | n | W (%) | n | W (%) | ||
Current smoking | 0.267 | |||||
Yes | 272 (20.7) | 240 | 88.3 | 32 | 11.7 | |
No | 1257 (79.3) | 1140 | 90.9 | 117 | 9.1 | |
Monthly drinking | 0.003 | |||||
Yes | 634 (45.9) | 587 | 93.2 | 47 | 6.8 | |
No | 895 (54.1) | 793 | 88.0 | 102 | 12.0 | |
Subjective health condition | <0.001 | |||||
Good | 221 (13.7) | 219 | 99.3 | 2 | 0.7 | |
Fair | 696 (47.1) | 669 | 96.6 | 27 | 3.4 | |
Poor | 612 (39.2) | 492 | 79.8 | 120 | 20.2 | |
Perceived stress | <0.001 | |||||
Low | 1204 (78.2) | 1139 | 95.2 | 65 | 4.8 | |
High | 325 (21.8) | 241 | 73.0 | 84 | 27.0 | |
Physical activity | 0.794 | |||||
Low | 982 (61.1) | 881 | 90.1 | 101 | 9.9 | |
Moderate to vigorous | 547 (38.9) | 499 | 91.2 | 48 | 8.8 | |
BMI (kg/m2), Mean ± SD | 25.23 ± 0.18 | 25.04 ± 0.11 | 25.42 ± 0.36 | 0.133 | ||
Underweight (<18.5) | 13 (0.7) | 11 | 94.7 | 2 | 5.3 | |
Normal (18.5 to 22.9) | 660 (42.4) | 590 | 89.7 | 70 | 10.3 | |
Overweight (23.0 to 24.9) | 607 (40.7) | 546 | 90.5 | 61 | 9.5 | |
Obesity (≥25.0) | 249 (16.3) | 233 | 94.0 | 16 | 6.0 |
Variables | Total | Without Depressive Symptoms (PHQ < 10) | With Depressive Symptoms (PHQ ≥ 10) | p-Value | ||
---|---|---|---|---|---|---|
(n = 1380) | (n = 149) | |||||
n (%) | n | W (%) | n | W (%) | ||
Diabetes duration (years), Mean ± SD | 11.33 ± 0.60 | 9.26 ± 0.58 | 13.39 ± 1.04 | <0.001 | ||
≤1 | 104 (7.3) | 99 | 95.8 | 5 | 4.2 | |
2–5 | 427 (29.9) | 389 | 91.6 | 38 | 8.4 | |
6–10 | 336 (22.8) | 300 | 90.9 | 36 | 9.1 | |
11–20 | 441 (26.6) | 405 | 91.5 | 36 | 8.5 | |
>20 | 221 (13.4) | 187 | 81.5 | 34 | 18.5 | |
Management of diabetes | 0.065 | |||||
Only OHA | 1294 (84.0) | 1176 | 91.3 | 118 | 8.7 | |
Only insulin | 22 (1.3) | 18 | 78.1 | 4 | 21.9 | |
OHA and insulin | 97 (6.2) | 84 | 82.7 | 13 | 17.3 | |
No medication | 6 (0.3) | 5 | 84.6 | 1 | 15.4 | |
No treatment | 110 (8.2) | 97 | 88.3 | 13 | 11.7 | |
A1C (%), n = 1415, Mean ± SD | 7.21 ± 0.07 | 7.25 ± 0.04 | 7.16 ± 0.14 | 0.843 | ||
< 7.0 | 722 (50.1) | 650 | 90.8 | 72 | 9.2 | |
≥7.0 | 693 (49.9) | 631 | 90.5 | 62 | 9.5 | |
Comorbid diseases | ||||||
Hypertension | 0.024 | |||||
Yes | 980 (60.6) | 874 | 88.7 | 106 | 11.3 | |
No | 549 (39.4) | 506 | 92.9 | 43 | 7.1 | |
Dyslipidemia | 0.482 | |||||
Yes | 735 (47.7) | 656 | 89.7 | 79 | 10.3 | |
No | 794 (52.3) | 724 | 91.0 | 70 | 9.0 | |
Stroke | <0.001 | |||||
Yes | 110 (7.0) | 85 | 76.3 | 25 | 23.7 | |
No | 1419 (93.0) | 1295 | 91.4 | 124 | 8.6 | |
Coronary heart disease | 0.001 | |||||
Yes | 141 (8.0) | 114 | 81.2 | 27 | 18.8 | |
No | 1388 (92.0) | 1266 | 91.1 | 122 | 8.9 |
Variables | Univariate Analysis | Multivariable Analysis | ||
---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | |
Sociodemographic variables | ||||
Sex | ||||
Male | 1 | 1 | ||
Female | 2.44 (1.56–3.84) | <0.001 | 1.22 (0.70–2.12) | 0.490 |
Educational level (years) | ||||
>12 (College and beyond) | 1 | 1 | ||
10–12 (High school) | 2.30 (0.99–5.36) | 0.053 | 1.45 (0.58–3.64) | 0.424 |
7–9 (Middle school) | 2.61 (1.10–6.23) | 0.030 | 1.20 (0.47–3.05) | 0.706 |
≤6 (Elementary school) | 4.03 (1.94–8.39) | <0.001 | 1.29 (0.56–2.95) | 0.551 |
Living | ||||
With spouse | 1 | 1 | ||
Without spouse | 2.90 (1.91–4.40) | <0.001 | 2.05 (1.30–3.24) | 0.002 |
Employment | ||||
Employed | 1 | 1 | ||
Unemployed | 3.16 (1.94–5.14) | <0.001 | 2.05 (1.11–3.77) | 0.021 |
Household income | ||||
High | 1 | 1 | ||
Medium–high | 1.621 (0.74–3.54) | 0.224 | 1.67 (0.72–3.84) | 0.230 |
Low–medium | 2.69 (1.22–5.92) | 0.014 | 1.87 (0.77–4.54) | 0.169 |
Low | 4.17 (1.96–8.86) | <0.001 | 2.95 (1.30–6.69) | 0.010 |
Health behavioral variables | ||||
Monthly drinking | ||||
Yes | 1 | 1 | ||
No | 1.88 (1.23–2.87) | 0.004 | 1.30 (0.81–2.10) | 0.280 |
Subjective health condition | ||||
Good | 1 | 1 | ||
Fair | 5.18 (1.15–23.34) | 0.032 | 5.21 (1.05–25.90) | 0.044 |
Poor | 36.91 (8.68–156.99) | <0.001 | 19.07 (4.11–88.39) | <0.001 |
Perceived stress | ||||
Low | 1 | 1 | ||
High | 7.31 (4.67–11.46) | <0.001 | 6.98 (4.27–11.40) | <0.001 |
BMI (kg/m2) | ||||
Normal (18.5 to 22.9) | 1 | 1 | ||
Underweight (<18.5) | 0.46 (0.08–2.83) | 0.403 | 0.11 (0.01–0.90) | 0.059 |
Overweight (23.0 to 24.9) | 0.71 (0.40–1.27) | 0.253 | 0.23 (0.39–1.80) | 0.236 |
Obesity (≥25.0) | 0.92 (0.57–1.48) | 0.731 | 0.84 (0.08–0.64) | 0.282 |
Diabetes-related variables | ||||
Diabetes duration (years) | ||||
≤1 | 1 | 1 | ||
2–5 | 2.11 (0.70–6.37) | 0.183 | 2.64 (0.79–8.77) | 0.120 |
6–10 | 2.31 (0.76–7.05) | 0.140 | 2.36 (0.69–8.01) | 0.169 |
11–20 | 2.15 (0.68–6.77) | 0.192 | 2.42 (0.69–8.53) | 0.169 |
>20 | 5.23 (1.65–16.57) | 0.005 | 3.89 (1.09–13.95) | 0.037 |
Management of diabetes | ||||
Only OHA | 1 | 1 | ||
Only insulin | 2.96 (0.86–10.20) | 0.086 | 2.81 (0.68–11.62) | 0.154 |
OHA and insulin | 2.20 (1.07–4.54) | 0.033 | 0.98 (0.35–2.74) | 0.970 |
No medication | 1.92 (0.21–17.28) | 0.561 | 6.21 (0.71–54.31) | 0.099 |
No treatment | 1.39 (0.68–2.86) | 0.365 | 1.21 (0.59–2.51) | 0.604 |
Comorbid diseases | ||||
Hypertension | ||||
No | 1 | 1 | ||
Yes | 1.67 (1.07–2.60) | 0.025 | 1.30 (0.76–2.23) | 0.330 |
Stroke | ||||
No | 1 | 1 | ||
Yes | 3.30 (1.80–6.06) | <0.001 | 1.94 (1.03–3.67) | 0.041 |
Coronary heart disease | ||||
No | 1 | 1 | ||
Yes | 2.38 (1.40–4.06) | 0.001 | 1.76 (0.96–3.23) | 0.138 |
Variables | Female (n = 780) | Male (n = 749) | ||
---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | |
Sociodemographic variables | ||||
Living | ||||
With spouse | 1 | 1 | ||
Without spouse | 1.74 (1.03–2.92) | 0.038 | 3.22 (1.23–8.44) | 0.018 |
Employment | ||||
Employed | 1 | 1 | ||
Unemployed | 1.83 (0.83–4.04) | 0.136 | 3.19 (1.31–7.75) | 0.011 |
Household income | ||||
High | 1 | |||
Medium–high | 2.45 (0.66–9.08) | 0.180 | ||
Low–medium | 2.86 (0.77–10.57) | 0.115 | ||
Low | 4.33 (1.22–15.37) | 0.024 | ||
Health behavioral variables | ||||
Monthly drinking | ||||
Yes | 1 | |||
No | 1.84 (0.90–3.77) | 0.093 | ||
Subjective health condition | ||||
Good | 1 | 1 | ||
Fair | 3.51 (0.40–30.48) | 0.254 | 7.52 (0.87–64.73) | 0.066 |
Poor | 16.76 (2.04–137.32) | 0.009 | 25.75 (3.05–217.49) | 0.005 |
Perceived stress | ||||
Low | 1 | 1 | ||
High | 4.69 (2.48–8.89) | <0.001 | 11.09 (4.95–24.88) | <0.001 |
BMI (kg/m2) | ||||
Normal (18.5 to 22.9) | 1 | |||
Underweight (<18.5) | 0.07 (0.01–0.69) | 0.023 | ||
Overweight (23.0 to 24.9) | 0.26 (0.09–0.71) | 0.009 | ||
Obesity (≥25.0) | 0.77 (0.36–1.64) | 0.496 | ||
Comorbid diseases | ||||
Hypertension | ||||
No | 1 | |||
Yes | 8.28 (2.72–25.21) | <0.001 | ||
Stroke | ||||
No | 1 | |||
Yes | 2.25 (1.03–4.91) | 0.042 | ||
Coronary heart disease | ||||
No | 1 | |||
Yes | 2.47 (1.14–5.38) | 0.023 |
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Jeong, M. Factors Associated with Depressive Symptoms in Korean Adults with Diabetes Mellitus: A Cross-Sectional Study. Healthcare 2021, 9, 1049. https://doi.org/10.3390/healthcare9081049
Jeong M. Factors Associated with Depressive Symptoms in Korean Adults with Diabetes Mellitus: A Cross-Sectional Study. Healthcare. 2021; 9(8):1049. https://doi.org/10.3390/healthcare9081049
Chicago/Turabian StyleJeong, Mihyun. 2021. "Factors Associated with Depressive Symptoms in Korean Adults with Diabetes Mellitus: A Cross-Sectional Study" Healthcare 9, no. 8: 1049. https://doi.org/10.3390/healthcare9081049